Post-hoc analysis of two gout remission definitions in a two-year randomized controlled trial of nurse-led versus usual gout care

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2024-09-18 DOI:10.1016/j.semarthrit.2024.152555

Adwoa Dansoa Tabi-Amponsah , Michael Doherty , Aliya Sarmanova , Weiya Zhang , Sarah Stewart , William J Taylor , Lisa K Stamp , Nicola Dalbeth

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引用次数: 0

Abstract

Objective

To compare the performance of the 2016 preliminary gout remission definition and a simplified gout remission definition in a clinical trial of nurse-led gout care.

Methods

Data from a 2-year parallel arm, non-blinded, randomised controlled trial of 517 community-derived people with gout were analyzed. Participants were assigned 1:1 to receive nurse-led care or general practitioner usual care. Remission was defined using the 2016 preliminary gout remission definition and a simplified gout remission definition without patient reported outcomes. Binary logistic regression was used to compare intervention groups. General linear models were used to compare Gout Impact Scale (GIS) scores between those in remission and those not in remission using either definition.

Results

Participants in the nurse-led care group were more likely to achieve remission using either definition; at Year 2 the odds ratio was 7.92 [95 % CI 4.86–12.92] using the 2016 preliminary definition and 11.88 [95 % CI 7.49–18.84] using the simplified definition. For all participants, the 2016 preliminary definition was fulfilled by 9.9 % at Year 1 and 28.4 % at Year 2, p < 0.001 and the simplified definition was fulfilled by 17.6 % at Year 1 and 42.7 % at Year 2, p < 0.001. People in remission using either definition had better gout outcomes assessed using the GIS, including greater control over their gout.

Conclusion

Both definitions discriminated between the intervention groups and showed high construct validity. The simplified definition identified more people as being in gout remission at Year 1 and Year 2. The simplified definition is a feasible and valid option for defining gout remission.

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在为期两年的护士指导与常规痛风护理随机对照试验中，对两种痛风缓解定义的事后分析

目的比较2016年初步痛风缓解定义和简化痛风缓解定义在护士主导的痛风护理临床试验中的表现。方法分析了一项为期2年、由517名社区痛风患者参加的平行臂、非盲法、随机对照试验的数据。参与者按1:1的比例被分配接受护士指导的护理或全科医生的常规护理。缓解采用2016年痛风缓解初步定义和简化痛风缓解定义，不含患者报告结果。二元逻辑回归用于比较干预组。结果无论采用哪种定义，护士主导护理组的参与者都更有可能实现缓解；在第二年，采用2016年初步定义的几率比为7.92 [95 % CI 4.86-12.92]，而采用简化定义的几率比为11.88 [95 % CI 7.49-18.84]。在所有参与者中，符合 2016 年初步定义的人数在第一年占 9.9%，在第二年占 28.4%，p <0.001；符合简化定义的人数在第一年占 17.6%，在第二年占 42.7%，p <0.001。结论两种定义都能区分干预组，并显示出较高的构建有效性。简化定义可识别出更多在第一年和第二年处于痛风缓解期的患者。简化定义是定义痛风缓解的一个可行且有效的选择。

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

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.