Stamp Lisa K, Frampton Chris, Stewart Sarah, Petrie Keith J, Edwards N Lawrence, Gaffo Angelo, Dalbeth Nicola
University of Otago, Christchurch, Christchurch, and Health New Zealand, Te Whatu Ora Waitaha, New Zealand.
University of Otago, Christchurch, Christchurch, New Zealand.
Arthritis Care Res (Hoboken). 2025 Jun;77(6):727-731. doi: 10.1002/acr.25494. Epub 2025 Jan 23.
Gout flares are the most important clinical feature of the disease. A hypothetical maximum flare occurrence in the preceding six months has been suggested to be no flares for a patient-acceptable symptom state (PASS) and only one flare for low disease activity (LDA). The aim of this analysis was to determine the relationship between gout flare states (PASS, LDA, and not in LDA or PASS [non-LDA/PASS]) and patient-reported outcomes.
Post hoc analyses of variance were undertaken using data from a 12-month randomized controlled trial involving 172 people with gout, which compared low-dose colchicine to placebo for the first 6 months while starting allopurinol with a further 6-month follow-up. Self-reported gout flares were collected monthly. Health Assessment Questionnaire (HAQ) and EuroQol 5-domain (EQ-5D-3L) were completed at 0, 3, 6 ,9, and 12 months, and the gout-specific brief illness perception questionnaire (BIPQ) was collected at months 0, 6, and 12.
In the final six months of the study, 68 participants (38%) were classified as being in PASS, 34 (19%) as in LDA, and 77 (43%) as non-LDA/PASS. There was no association between gout flare states and EQ-5D-3L or HAQ. There was a statistically significant association between three of eight BIPQ items with increasing consequences, identity, and concern scores across the three states of PASS, LDA, and non-LDA/PASS.
The majority of people were able to achieve gout flare PASS or LDA in the second six months after commencing allopurinol. As flare burden increases, so does the impact of gout on the patient. These findings highlight the importance of flare prevention in the management of gout.
痛风发作是该疾病最重要的临床特征。有人提出，对于患者可接受的症状状态（PASS），假设在前六个月中最大发作次数为无发作；对于疾病活动度低（LDA），则为仅有一次发作。本分析的目的是确定痛风发作状态（PASS、LDA以及不在LDA或PASS范围内[非LDA/PASS]）与患者报告的结局之间的关系。
使用一项为期12个月的随机对照试验的数据进行事后方差分析，该试验涉及172名痛风患者，前6个月将小剂量秋水仙碱与安慰剂进行比较，同时开始使用别嘌醇并进行为期6个月的随访。每月收集自我报告的痛风发作情况。在第0、3、6、9和12个月完成健康评估问卷（HAQ）和欧洲五维健康量表（EQ-5D-3L），并在第0、6和12个月收集痛风特异性简短疾病认知问卷（BIPQ）。
在研究的最后六个月中，68名参与者（38%）被归类为处于PASS状态，34名（19%）处于LDA状态，77名（43%）处于非LDA/PASS状态。痛风发作状态与EQ-5D-3L或HAQ之间无关联。在PASS、LDA和非LDA/PASS这三种状态下，八项BIPQ项目中的三项与后果、认同感和关注度得分增加之间存在统计学上的显著关联。
在开始使用别嘌醇后的第二个六个月中，大多数人能够实现痛风发作的PASS或LDA状态。随着发作负担的增加，痛风对患者的影响也会增加。这些发现凸显了预防发作在痛风管理中的重要性。
