Performance of Two Gout Remission Definitions in a Two-Year Randomized Controlled Trial of Nurse-led Care

Dansoa Tabi-Amponsah¹, Michael Doherty², Aliya Sarmanova³, Weiya Zhang², Sarah Stewart⁴, William Taylor⁵, Lisa Stamp⁶ and Nicola Dalbeth⁷, ¹The University of Auckland, Auckland, New Zealand, ²Academic Rheumatology, School of Medicine, University of Nottingham; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, United Kingdom, ³Roche Diagnostics International, Clinical Development and Medical Affairs, Nottingham, England, United Kingdom, ⁴Auckland University of Technology, Auckland, New Zealand, ⁵The University of Otago, Wellington, Wellington, New Zealand, ⁶University of Otago, Christchurch, Christchurch, New Zealand, ⁷University of Auckland, Auckland, New Zealand

Meeting: ACR Convergence 2024

Keywords: gout, Health Care, Nursing, Outcome measures, Uric Acid, Urate

Session Information

Date: Saturday, November 16, 2024

Title: Metabolic & Crystal Arthropathies – Basic & Clinical Science Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: 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 were analyzed from a 2-year parallel arm, non-blinded, randomised controlled trial of 517 people with gout, in which participants were assigned 1:1 to receive nurse-led care or usual care¹. Remission was defined using the 2016 preliminary gout remission definition² and a simplified gout remission definition (without serial measures of patient global assessment and pain scores). Binary logistic regression was used to compare intervention groups. Gout-specific quality of life was assessed using items from the Gout Impact Scale (GIS), measured on a 0-100 scale. General linear models were used to compare GIS scores between those in remission and those not in remission using either definition.

Results: During the trial participants in the nurse-led 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 (Table 1). For all participants, remission was more common using either definition in Year 2 than Year 1 (p< 0.001), and at both Year 1 and Year 2 more participants were defined as being in remission using the simplified definition compared with the 2016 preliminary definition (p< 0.001). People in remission using either definition had better gout outcomes assessed using the GIS, including greater control over their gout, with a mean difference of 9.85 [95% CI 3.95-15.74], p< 0.001 using the preliminary definition, and a mean difference of 9.87 [95% CI 3.72-16.01], p= 0.002 using the simplified definition.

Conclusion: The 2016 preliminary gout remission definition and the simplified gout remission definition both discriminated well between nurse-led and usual care groups. The simplified definition identified more people in both groups as being in gout remission and showed high construct validity using a gout-specific health related quality of life instrument. The simplified definition is a feasible and valid option for defining gout remission in gout clinical trials.

1. Doherty et al, Lancet 2018;392:1403-12

2. de Lautour et al, Arthritis Care Res 2016;68:667-72

Table 1. Proportion of participants in remission by intervention group

Disclosures: D. Tabi-Amponsah: None; M. Doherty: None; A. Sarmanova: Roche, 3; W. Zhang: None; S. Stewart: None; W. Taylor: None; L. Stamp: Uptodate, 9; N. Dalbeth: Arthrosi, 2, AstraZeneca, 5, 6, Avalo Therapeutics, 2, Dexcel Pharma, 2, Hikma, 6, Horizon, 2, 6, JPI, 2, JW Pharmaceutical Corporation, 2, LG Chem, 2, Novartis, 6, PK Med, 2, Protalix, 2, PTC Therapeutics, 2, Selecta, 2, Shanton Pharma, 2, Sobi, 2, Unlocked Labs, 2.

To cite this abstract in AMA style:

Tabi-Amponsah D, Doherty M, Sarmanova A, Zhang W, Stewart S, Taylor W, Stamp L, Dalbeth N. Performance of Two Gout Remission Definitions in a Two-Year Randomized Controlled Trial of Nurse-led Care [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/performance-of-two-gout-remission-definitions-in-a-two-year-randomized-controlled-trial-of-nurse-led-care/. Accessed .

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