Outcome Measures in Acute Gout: A Systematic Literature Review

Abstract

Objective Five core domains have been endorsed by Outcomes Measures in Rheumatology (OMERACT) for acute gout: pain, joint swelling, joint tenderness, patient global assessment, and activity limitation. The aim of this work was to evaluate instruments for these domains according to the OMERACT filter: truth, feasibility, and discrimination. Methods A systematic search strategy for instruments used to measure the acute gout core domains was formulated. For each method, articles were assessed by two reviewers to summarise information according to the specific components of the OMERACT filter. Results Seventy-seven articles and abstracts met the inclusion criteria. Pain was most frequently reported (76 studies, 20 instruments). The pain instruments used most often were 100mm visual analog scale (VAS) and 5-point Likert scale. Both methods have high feasibility, face and content validity, within- and between-group discrimination. Four-point Likert scales assessing index joint swelling and tenderness have been used in numerous acute gout studies; these instruments are feasible, with high face and content validity, and show within- and between-group discrimination. Five-point patient global assessment of response to treatment (PGART) scales are feasible and valid, and show within- and between-group discrimination. Measures of activity limitations were infrequently reported, and insufficient data were available to make definite assessments of the instruments for this domain. Conclusion Many different instruments have been used to assess the acute gout core domains. Pain VAS and 5-point Likert scales, 4-point Likert scales of index joint swelling and tenderness and 5-point PGART instruments meet the criteria for the OMERACT filter.

What Outcomes are Important for Gout Patients? In-Depth Qualitative Research into the Gout Patient Experience to Determine Optimal Endpoints for Evaluating Therapeutic Interventions

“…Consistent with the literature [8, 19, 36, 37], CE activities (both patient and clinician interviews and qualitative digital ethnography) identified pain as being the cardinal, defining symptom of gout, leading to a range of impacts on QoL. In particular, this study found that patients discussed severe debilitating flares of pain causing an inability to weight bear and an impact on physical functioning (e.g., difficulty walking), sleep, daily activities, and work (e.g., productivity) and social activities (e.g., missing/cancelling plans).…”

High Level Serum Procalcitonin Associated Gouty Arthritis Susceptibility: From a Southern Chinese Han Population

“…Diagnostic criteria were completed each of the recruited patients accordingly GA (ACR 1997), RA (revised ACR 2010), AS (ACR1984). Visual analogue scales (VAS) 0–10cm were applied in GA (mean 4.07 ± 1.15) [ 13 ]. In RA composite disease activity measures included the clinical disease activity and 28 joint disease activities score (DAS28) mean value is 4.97 ± 1.12 [ 14 , 15 ] and in AS disease activity are decided as per ankylosing spnodolylitis disease activity score (ASDAS) mean value 2.97 ± 0.81 [ 16 ].…”

Gout: an Asia‐Pacific update

“…Five core domains have been endorsed by OMERACT for acute gout: pain, joint swelling, joint tenderness, patient global assessmen and activity limitation. 47 The Gout Special Interest Group is trying to identify domains of interest and is now evaluating a series of outcomes for features of chronic gout, such as serum uric acid level, physical measurement or digital photography of tophi and imaging modalities. 48,49 Gout-specific patient reported outcome instruments like the Gout Assessment Questionnaire (GAQ) were also developed that collect information about gout impact, assessing pain, well-being, productivity and treatment satisfaction.…”

“…Lesinurad 67 is a urate transport inhibitor (inhibits URAT 1 and OAT 4 in renal tubules 47 ) for treating hyperuricemia associated with gout in patients who have not achieved target serum uric acid levels with a xanthine oxidase inhibitor alone. It very recently received US Food and Drug Administration approval.…”