Impact of gout flare on health-related quality of life: a multi-center cross-sectional study in Thailand.

Objective: Although the 5-level EQ-5D version (EQ-5D-5L) instrument has been used to determine health-related quality of life and health utility in gout, it is used in comparing health utility among gout flare (GF) and non-gout flare (non-GF) patients is still limited. This study aimed to compare health utility among GF and non-GF patients in Thailand.

Methods: In this multi-center cross-sectional study, patients with GF and non-GF were interviewed for the EQ-5D5L and EQ-Visual Analog Scale (VAS) instruments by rheumatologists or trained research staffs. Patients with GF were subdivided into 2 subgroups (those who received no treatment and those who received treatment less than 48 h after GF episode).

Results: Two hundred and sixteen patients (108 GF and 108 non-GF patients), males in 90.28%, were included. The gout disease duration was significantly longer in the non-GF than in the GF groups (median, 10 vs 5 years; p = 0.004). There was no difference in the tophi present between the two groups. When compared with the non-GF group, the GF patients significantly had low health utility (0.34 ± 0.36 vs. 0.89 ± 0.15, p < 0.001) and EQ-VAS score (54.73 ± 25.14 vs. 84.06 ± 13.38, p < 0.001). In the subgroup analysis of the non-GF group, there was insignificant health utility and EQ-VAS score between those with tophi and those without tophi (0.87 ± 0.14 vs. 0.90 ± 0.15, p = 0.124 and 83.36 ± 14.92 vs. 84.33 ± 12.83, p = 0.938, respectively).

Conclusion: This study found that GF clearly had a substantial impact on patients' quality of life. Targeted interventions in managing GF patients to improve their health outcomes are needed. Key Points • Patients with gout flare had lower health utility than those without gout flare. • The clinical significance of the utility and EQ-VAS was evaluated by the EQ-5D-5L instrument between gout flare and non-gout flare groups in Thai gouty patients. • Regarding the presence of tophi or disease duration, no significant differences in health utility and EQ-VAS were observed in the gout flare or non-gout flare group. • Targeted interventions for management of gout flare are needed to improve the health outcomes of gout flare patients.