A.D. Tabi-Amponsah, BBiomedSc(Hons), A. Horne, MBChB, G. Gamble, MSc, N. Dalbeth, MD, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland.
L.K. Stamp, PhD, Department of Medicine, University of Otago, Christchurch, Christchurch.
J Rheumatol. 2024 Nov 1;51(11):1135-1140. doi: 10.3899/jrheum.2024-0400.
To investigate (1) the effect of colchicine prophylaxis on gout remission when commencing urate-lowering therapy (ULT), and (2) illness perceptions of people in remission using 2 definitions of gout remission.
Data from a 12-month double-blind placebo-controlled trial of 200 people with gout commencing allopurinol were analyzed. Participants were randomly assigned to prophylaxis with 0.5 mg daily colchicine or placebo for 6 months, followed by 6 months of additional follow-up. Gout remission was assessed using the 2016 preliminary definition or simplified definition without patient-reported outcomes. Illness perceptions were assessed using a gout-specific version of the Brief Illness Perception Questionnaire.
In the first 6 months, few participants were in remission according to either the 2016 preliminary definition (3% for colchicine and 4% for placebo) or the simplified definition (7% for colchicine and 12% for placebo). In the second 6 months, after study drug (colchicine or placebo) discontinuation, fewer participants in the colchicine group than in the placebo group were in remission according to the 2016 preliminary definition (4% vs 14%, = 0.03), and the simplified definition (14% vs 28%, = 0.02). Participants fulfilling remission using either definition had more favorable perceptions about their gout symptoms and illness concerns, as well as consequences, when using the simplified definition.
Using either definition, 6 months of colchicine prophylaxis when initiating ULT does not provide an advantage in the fulfillment of gout remission. People fulfilling either definition report fewer symptoms, less concern about their gout, and, when using the simplified definition, are less affected by gout.
探究（1）在开始降尿酸治疗（ULT）时秋水仙碱预防对痛风缓解的影响，以及（2）使用两种痛风缓解定义时缓解期人群的疾病认知。
分析了 200 名开始服用别嘌醇的痛风患者进行的为期 12 个月、双盲、安慰剂对照试验的数据。参与者被随机分配接受为期 6 个月的每日 0.5 毫克秋水仙碱或安慰剂预防治疗，随后进行 6 个月的额外随访。使用 2016 年初步定义或简化定义（无患者报告结果）评估痛风缓解情况。使用简化版Brief 疾病认知问卷评估疾病认知。
在前 6 个月，根据 2016 年初步定义（秋水仙碱组 3%，安慰剂组 4%）或简化定义（秋水仙碱组 7%，安慰剂组 12%），很少有参与者处于缓解期。在后 6 个月，停止研究药物（秋水仙碱或安慰剂）后，根据 2016 年初步定义，秋水仙碱组中处于缓解期的参与者少于安慰剂组（4%比 14%， = 0.03），根据简化定义（14%比 28%， = 0.02）。根据任一定义，处于缓解期的参与者对其痛风症状和疾病关注度以及后果的看法更为有利，尤其是简化定义。
使用任一定义，在开始 ULT 时使用 6 个月的秋水仙碱预防并不能在痛风缓解方面提供优势。符合任一定义的患者报告症状更少，对痛风的担忧更少，并且，使用简化定义时，受痛风的影响更小。
