Analysis of Gout Remission Definitions in a Randomized Controlled Trial of Colchicine Prophylaxis for People With Gout Initiating Allopurinol.

IF 3.6 2区 医学 Q2 RHEUMATOLOGY
Adwoa Dansoa Tabi-Amponsah, Lisa K Stamp, Anne Horne, Jill Drake, Sarah Stewart, Greg Gamble, Keith J Petrie, Nicola Dalbeth
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引用次数: 0

Abstract

Objective: 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.

Methods: 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.

Results: 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%, P = 0.03), and the simplified definition (14% vs 28%, P = 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.

Conclusion: 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.

对开始使用别嘌醇的痛风患者使用秋水仙碱预防的随机对照试验中痛风缓解定义的分析。
目的采用两种痛风缓解的定义,研究秋水仙碱预防性治疗对开始降尿酸盐疗法(ULT)时痛风缓解的影响,以及缓解期患者对疾病的看法:分析了一项为期 12 个月的双盲安慰剂对照试验的数据,该试验针对 200 名开始接受别嘌醇治疗的痛风患者。参与者被随机分配到每天服用 0.5 毫克秋水仙碱或安慰剂进行预防治疗,为期 6 个月,之后再进行 6 个月的随访。痛风缓解采用2016年初步定义或简化定义进行评估,不含患者报告结果。疾病感知采用痛风特异性简短疾病感知问卷(BIPQ)进行评估:在前六个月中,无论是根据2016年初步定义(3%的患者使用秋水仙碱,4%的患者使用安慰剂)还是简化定义(7%的患者使用秋水仙碱,12%的患者使用安慰剂),很少有参与者病情得到缓解。在研究药物(秋水仙碱或安慰剂)停药后的6个月中,根据2016年初步定义(4%对14%,P=0.03)和简化定义(14%对28%,P=0.02),秋水仙碱组的缓解人数少于安慰剂组。无论采用哪种定义,达到缓解的参与者对痛风症状、疾病问题以及后果的看法都比采用简化定义的参与者更有利:结论:无论采用哪种定义,在开始超低频治疗时服用 6 个月秋水仙碱预防性治疗并不会为痛风缓解带来优势。无论采用哪种定义,患者的症状都较少,对痛风的担忧程度也较低,而且在使用简化定义时,痛风对患者的影响也较小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Rheumatology
Journal of Rheumatology 医学-风湿病学
CiteScore
6.50
自引率
5.10%
发文量
285
审稿时长
1 months
期刊介绍: The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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