Baseline Dual-Energy Computed Tomography Urate Volume Predicts Fulfillment of Gout Remission After Two Years of Urate-Lowering Therapy.

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Adwoa Dansoa Tabi-Amponsah, Sarah Stewart, Greg Gamble, Anthony J Doyle, Karen Billington, Chang-Nam Son, Kieran Latto, Lisa K Stamp, William J Taylor, Anne Horne, Nicola Dalbeth
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Abstract

Objective: This study aimed to identify variables that predict gout remission in people with erosive gout receiving urate-lowering therapy.

Methods: We analyzed data from a two-year, double-masked randomized-controlled trial of people with erosive gout, randomized to a serum urate target of <0.20 mmol/L or <0.30 mmol/L using oral urate-lowering therapies. All participants had dual-energy computed tomography (DECT) scans of the feet and ankles at baseline. The proportion of participants achieving gout remission according to the 2016 preliminary gout remission criteria and simplified gout remission criteria (without the patient reported outcomes) was analyzed. Logistic regression models were used to evaluate predictors of gout remission in year 2.

Results: The preliminary gout remission criteria were fulfilled in 11 of 97 participants (11%) at year 1 and 21 of 92 participants (23%) at year 2. The simplified criteria were fulfilled in 26 of 97 participants (27%) in year 1 and 40 of 92 participants (44%) in year 2. In multivariable regression models, baseline DECT monosodium urate crystal volume was the only significant independent predictor of gout remission at year 2, using either criteria. Each 1-cm3 increase in the baseline DECT monosodium urate crystal volume decreased the odds of fulfilling the 2016 preliminary gout remission criteria (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.46-0.93; P = 0.02) and the simplified gout remission criteria (OR 0.57, 95% CI 0.41-0.78; P < 0.001).

Conclusion: In people with erosive gout on urate-lowering therapy, higher baseline DECT monosodium urate crystal volume is associated with lower odds of gout remission after two years of treatment, defined by either the preliminary gout remission criteria or simplified gout remission criteria.

基线双能计算机断层扫描尿酸盐容量可预测降尿酸治疗两年后痛风缓解的实现情况。
研究目的本研究旨在确定可预测接受降尿酸治疗的侵蚀性痛风患者痛风缓解的变量:我们分析了一项为期两年的侵蚀性痛风患者双盲随机对照试验的数据:第一年有 11/97 人(11%)符合痛风缓解初步标准,第二年有 21/92 人(23%)符合标准。第一年有 26/97 人(27%)符合简化标准,第二年有 40/92 人(44%)符合简化标准。在多变量回归模型中,无论采用哪种标准,基线 DECT 尿酸单钠晶体体积都是第二年痛风缓解的唯一重要独立预测因素。基线DECT单钠尿酸盐晶体体积每增加1立方厘米,符合2016年初步痛风缓解标准(0.65 [95% CI 0.46-0.93],p=0.02)和简化痛风缓解标准(0.57 [95% CI 0.41-0.78],p结论:在接受降尿酸治疗的侵蚀性痛风患者中,根据初步痛风缓解标准或简化痛风缓解标准,基线DECT单钠尿酸盐晶体体积越大,治疗两年后痛风缓解的几率越低。
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
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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