The challenge of gout flare measurement

2021 ◽  
pp. 101716
Author(s):  
Sarah Stewart ◽  
Nicola Dalbeth ◽  
Angelo Gaffo
Keyword(s):  
Gout Flare

Prophylaxis of gout flare with colchicine and vitamin C

2013 ◽  
Author(s):  
Simeon Monov ◽  
Daniela Monova ◽  
Rasho Rashkov
Keyword(s):  
Vitamin C ◽  
Gout Flare

scholarly journals Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Huai Leng Pisaniello ◽  
Mark C. Fisher ◽  
Hamish Farquhar ◽  
Ana Beatriz Vargas-Santos ◽  
Catherine L. Hill ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Literature Review ◽  
Interleukin 1 ◽  
Treatment Options ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Clinical Trial Results ◽  
Gout Flare

AbstractGout flare prophylaxis and therapy use in people with underlying chronic kidney disease (CKD) is challenging, given limited treatment options and risk of worsening renal function with inappropriate treatment dosing. This literature review aimed to describe the current literature on the efficacy and safety of gout flare prophylaxis and therapy use in people with CKD stages 3–5. A literature search via PubMed, the Cochrane Library, and EMBASE was performed from 1 January 1959 to 31 January 2018. Inclusion criteria were studies with people with gout and renal impairment (i.e. estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) < 60 ml/min/1.73 m2), and with exposure to colchicine, interleukin-1 inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and glucocorticoids. All study designs were included. A total of 33 studies with efficacy and/or safety analysis stratified by renal function were reviewed—colchicine (n = 20), anakinra (n = 7), canakinumab (n = 1), NSAIDs (n = 3), and glucocorticoids (n = 2). A total of 58 studies reported these primary outcomes without renal function stratification—colchicine (n = 29), anakinra (n = 10), canakinumab (n = 6), rilonacept (n = 2), NSAIDs (n = 1), and glucocorticoids (n = 10). Most clinical trials excluded study participants with severe CKD (i.e. eGFR or CrCl of < 30 mL/min/1.73 m2). Information on the efficacy and safety outcomes of gout flare prophylaxis and therapy use stratified by renal function is lacking. Clinical trial results cannot be extrapolated for those with advanced CKD. Where possible, current and future gout flare studies should include patients with CKD and with study outcomes reported based on renal function and using standardised gout flare definition.

scholarly journals THU0447 HOME-MONITORING GOUT FLARES WITH A SMARTPHONE APP – RESULTS OF A FEASIBILITY STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 460.1-461
Author(s):  
B. Pouls ◽  
C. Bekker ◽  
B. Van den Bemt ◽  
A. Gaffo ◽  
M. Flendrie
Keyword(s):  
Technology Acceptance ◽  
Real Time ◽  
Technology Acceptance Model ◽  
Home Monitoring ◽  
Added Value ◽  
Smartphone App ◽  
Research Support ◽  
Acceptance Model ◽  
Gout Flare ◽  
Gout Flares

Background:Gout flares are considered a key clinical and research outcome in gout. Early treatment of gout flares increases patient well-being and warrants timely notification of the treating clinician.Objectives:To test the feasibility of a smartphone app to home-monitor gout flares real-time for both patients with a suspicion of and established gout.Methods:Thirty patients were recruited during their visit at the outpatient rheumatology clinic. Inclusion criteria were age ≥ 18 years, smartphone possession, established gout (crystal proven) or a clinical suspicion of gout and at least one flare reported in the last three months.A straight-forward query app was used to incorporate an adapted version of the 2017 four-criteria gout flare definition.[1] For 90 consecutive days the app asked patients to report their current pain score on an 11-points scale as screening question. Scoring pain below 4 terminated the query, otherwise the app posed the remaining criteria: does the patient experience warm and/or swollen joints and are symptoms regarded as a gout flare. Responses were transmitted in real-time to the dashboard and the clinician was alerted via email if predefined conditions were met. End of study evaluation consisted of the number of generated alerts, duration of (possible) flares and actions taken. Patient feasibility was assessed by measuring app attrition and using a questionnaire based on the Technology Acceptance Model. [2] All constructs were analysed using descriptive statistics.Results:All 30 recruited patients finished the trial. Three minor, resolvable technical issues were reported. Seventeen participants never missed a question. In total 110 responses (4.1%) were missed with three participants responsible for 66 missings. 90% of the participants rated app usability good to excellent and 70% would recommend the app to other patients.Twelve out of thirty patients generated a total amount of 174 alerts where four patients with a suspicion of gout were responsible for 148 alerts (85%). These patients scored three out of four criteria as they had warm, swollen and painful joints but, after consultation with the clinician, their symptoms were not regarded as a gout flare.The 174 alerts belonged to 23 (possible) flares with a median duration of 5 days [IQR 3,5 – 7,5]. Twenty-one pro-active telephone calls were made which resulted in four visits to the clinic within 48 hours. Clinical guidance over the phone consisted of checking in on patient’s symptoms, giving advice and ten medication adjustments.Conclusion:This prospective study shows feasibility of a smartphone app for home-monitoring gout flares for patients because of high usability scores and low attrition rates. The app has added value for gout care because it enables clinicians to act on flares as they occur. The next step is to further implement the app whilst perpetuating investigation into the added value for patients and clinical practice alike.References:[1]Gaffo AL, Dalbeth N, Saag KG, et al. Brief Report: Validation of a Definition of Flare in Patients With Established Gout. Arthritis Rheumatol. 2018;70(3):462-467.[2]Davis Jr. FD. A Technology Acceptance Model for empirically testing new end-user information systems: theory and results. MIT PhD thesis. 1985[3]Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS). JMIR Mhealth Uhealth. 2016;4(2):e72.Acknowledgements:This study was funded by AbbVie and Menarini.Disclosure of Interests: :Bart Pouls: None declared, Charlotte Bekker: None declared, Bart van den Bemt Grant/research support from: UCB, Pfizer and Abbvie, Consultant of: Delivered consultancy work for UCB, Novartis and Pfizer, Speakers bureau: Pfizer, AbbVie, UCB, Biogen and Sandoz., Angelo Gaffo Grant/research support from: Received a research grant from AMGEN, Marcel Flendrie Grant/research support from: M. Flendrie has received grants from Menarini and Grunenthal., Consultant of: M. Flendrie has received consultancy fees from Menarini and Grunenthal.

scholarly journals Serum uric acid control for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan

2021 ◽  
pp. annrheumdis-2021-220439
Author(s):  
Ruriko Koto ◽  
Akihiro Nakajima ◽  
Hideki Horiuchi ◽  
Hisashi Yamanaka
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Health Insurance ◽  
Serum Uric Acid ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Disease Status ◽  
Insurance Claims ◽  
Health Insurance Claims ◽  
Gout Flare

ObjectivesIn patients with gout, treating to target serum uric acid levels (sUA) of ≤6.0 mg/dL is universally recommended to prevent gout flare. However, there is no consensus on asymptomatic hyperuricaemia. Using Japanese health insurance claims data, we explored potential benefits of sUA control for preventing gout flare in subjects with asymptomatic hyperuricaemia.MethodsThis retrospective cohort study analysed the JMDC Claims Database from April 2012 through June 2019. Subjects with sUA ≥8.0 mg/dL were identified, and disease status (prescriptions for urate-lowering therapy (ULT), occurrence of gout flare, sUA) was investigated for 1 year. Time to first onset and incidence rate of gout flare were determined by disease status subgroups for 2 years or more. The relationship between gout flare and sUA control was assessed using multivariable analysis.ResultsThe analysis population was 19 261 subjects who met eligibility criteria. We found fewer occurrences of gout flare, for both gout and asymptomatic hyperuricaemia, in patients who achieved sUA ≤6.0 mg/dL with ULT than in patients whose sUA remained >6.0 mg/dL or who were not receiving ULT. In particular, analysis by a Cox proportional-hazard model for time to first gout flare indicated that the HR was lowest, at 0.45 (95% CI 0.27 to 0.76), in subjects with asymptomatic hyperuricaemia on ULT (5.0<sUA ≤ 6.0 mg/dL), compared with untreated subjects (sUA ≥8.0 mg/dL).ConclusionsOccurrences of gout flare were reduced by controlling sUA at ≤6.0 mg/dL in subjects with asymptomatic hyperuricaemia as well as in those with gout.Trial registration numberUMIN000039985.

FRI0399 Rilonacept for GOUT flare prevention in patients initiating uric acid-lowering therapy: Efficacy in patient subpopulations

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 449.2-449
Author(s):  
R. Evans ◽  
R. Terkeltaub ◽  
E. Mitha ◽  
J. Wang ◽  
C. Barton ◽  
...  
Keyword(s):  
Uric Acid ◽  
Therapy Efficacy ◽  
Lowering Therapy ◽  
Gout Flare

scholarly journals Prognostic factors associated with early gout flare recurrence in patients initiating urate-lowering therapy during an acute gout flare

2019 ◽  
Vol 38 (8) ◽  
pp. 2233-2239 ◽  
Author(s):  
C. A. Janssen ◽  
M. A. H. Oude Voshaar ◽  
P. M. ten Klooster ◽  
H. E. Vonkeman ◽  
M. A. F. J. van de Laar
Keyword(s):  
Prognostic Factors ◽  
Acute Gout ◽  
Factors Associated ◽  
Lowering Therapy ◽  
Gout Flare

scholarly journals Correction to: Anakinra for colchicine-intolerant/colchicine-resistant acute gout flare precipitated by decompensated heart failure

2020 ◽  
Author(s):  
Muhammad Hamza Saad Shaukat ◽  
Muhammad Asim Shabbir ◽  
Sukhraj Singh ◽  
Mikhail Torosoff ◽  
Ruben Peredo-Wende
Keyword(s):  
Heart Failure ◽  
Decompensated Heart Failure ◽  
Acute Gout ◽  
Gout Flare
Sign in / Sign up

Export Citation Format

Share Document