痛风缓解是可能的：norg - gout研究的5年随访

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-02-27 DOI:10.1016/j.semarthrit.2025.152698

Till Uhlig , Johan Stjärne , Lars Fridtjof Karoliussen , Joe Sexton , Tron Eskild , Sella Aarrestad Provan , Espen André Haavardsholm , Hilde Berner Hammer

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引用次数: 0

摘要

目的：通过5年随访，比较观察性治疗-目标患者队列中痛风缓解定义的表现。方法入选标准为明确证实的痛风伴血清尿酸水平升高和发作。根据2016年初步痛风缓解定义确定缓解，这是一个修改的初步定义，对痛风引起的疼痛和患者痛风疾病活动性的整体评估的个体变量具有更宽松的阈值，以及没有患者报告结果的简化定义。线性混合模型用于比较SF-36物理（PCS）和精神（MCS）组件的生活质量以及半定量双能量断层扫描（DECT）在满足和不满足每个缓解定义的患者中的结构损伤。结果对211例患者（平均年龄56.4岁，95.3%为男性）的数据进行了分析，这些患者纳入了为期一年的强化治疗-目标干预，随访时间分别为1年、2年和5年。在1年、2年和5年的初步定义中，缓解的频率都有所增加（分别为4.6%、22.1%和42.8%），而修改后的初步定义中，缓解的频率分别为5.1%、28.4%和44.1%。%)和简化定义（7.7%、45.4%和58.6%）(p <；0.001对于所有定义)。在第2年和第5年，简化定义比初步定义和修改的初步定义确定了更多的缓解患者。所有这三个定义区分为SF-36 MCS， pc或DECT。结论痛风降尿酸治疗后1年缓解率低，5年缓解率高，简化定义后缓解率最高。缓解定义显示生活质量和结构变化同时有效。

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Remission in gout is possible: 5-year follow-up in the NOR-Gout study

Objective

To compare the performance of remission definitions for gout in an observational treat-to-target patient cohort with 5 years of follow-up.

Methods

Inclusion criteria were crystal proven gout with increased serum urate levels and a flare. Remission was determined according to the 2016 preliminary gout remission definition, a modified preliminary definition with more lenient thresholds for the individual variables pain due to gout and patient global assessment of gout disease activity, and the simplified definition without patient reported outcomes. Linear mixed models were used to compare quality of life with SF-36 physical (PCS) and mental (MCS) components and structural damage with semiquantitative dual energy tomography (DECT) across patients fulfilling and not fulfilling each remission definition.

Results

Data were analysed from 211 patients (mean age 56.4 years, 95.3 % males) included in an intensive one-year treat-to-target intervention with follow-up at 1, 2, and 5 years. The frequency of remission increased for both the preliminary definition at 1, 2 and 5 years (4.6 %, 22.1 %, and 42.8 %), the modified preliminary definition (5.1 %, 28.4 %, and 44.1. %) and the simplified definition (7.7 %, 45.4 %, and 58.6 %)(p < 0.001 for all definitions). The simplified definition identified more patients in remission than the preliminary and the modified preliminary definition at years 2 and 5. All three definitions discriminated for SF-36 MCS, PCS or DECT.

Conclusion

Remission in gout after urate lowering therapy was seldom after 1 but high after 5 years and was highest for the simplified definition. Remission definitions showed concurrent validity for quality of life and structural changes.

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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.