Development and First Validation of a Disease Activity Score for Gout. Issue 10 (6th September 2016)

• Record Type: Journal Article
• Authors: Scirè, Carlo A.; Carrara, Greta; Viroli, Cinzia; Cimmino, Marco A.; Taylor, William J.; Manara, Maria; Govoni, Marcello; Salaffi, Fausto; Punzi, Leonardo; Montecucco, Carlomaurizio; Matucci‐Cerinic, Marco; Minisola, Giovanni
• Other Names: Ariani Alarico investigator.; Galossi Alessandra investigator.; Lauriti Ciro investigator.; Fracassi Elena investigator.; Idolazzi Luca investigator.; Bardelli Marco investigator.; Selvi Enrico investigator.; Tirri Enrico investigator.; Furini Federica investigator.; Inverardi Flora investigator.; Calabrò Andrea investigator.; Porta Francesco investigator.; Bittelli Raffaele investigator.; Venturino Francesco investigator.; Capsoni Franco investigator.; Prevete Immacolata investigator.; Sebastiani Giandomenico investigator.; Selmi Carlo investigator.; Fabbriciani Gianluigi investigator.; D'Avola Giovanni investigator.; Botticella Giulia investigator.; Serale Francesca investigator.; Seminara Giulia investigator.; D'Alessandro Giuseppe investigator.; Santo Leonardo investigator.; Longato Lorena investigator.; Zaccara Eleonora investigator.; Sinigaglia Luigi investigator.; Atteritano Marco investigator.; Broggini Marco investigator.; Caprioli Marta investigator.; Favero Marta investigator.; Sallì Salvatore investigator.; Scarati Marco investigator.; Parisi Simone investigator.; Malavolta Nazzarena investigator.; Corvaglia Stefania investigator.; Scarpato Salvatore investigator.; Veneto Vittorio investigator.;
• Is Part Of: Arthritis care & research. Volume 68:Issue 10(2016:Oct.)
• Page Start: 1530
• Page End: 1537
• Publication Date: 2016-09-06
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.22844
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : Objective: To develop a new composite disease activity score for gout and provide its first validation. Methods: Disease activity has been defined as the ongoing presence of urate deposits that lead to acute arthritis and joint damage. Every measure for each Outcome Measures in Rheumatology core domain was considered. A 3‐step approach (factor analysis, linear discriminant analysis, and linear regression) was applied to derive the Gout Activity Score (GAS). Decision to change treatment or 6‐month flare count were used as the surrogate criteria of high disease activity. Baseline and 12‐month followup data of 446 patients included in the Kick‐Off of the Italian Network for Gout cohort were used. Construct‐ and criterion‐related validity were tested. External validation on an independent sample is reported. Results: Factor analysis identified 5 factors: patient‐reported outcomes, joint examination, flares, tophi, and serum uric acid (sUA). Discriminant function analysis resulted in a correct classification of 79%. Linear regression analysis identified a first candidate GAS including 12‐month flare count, sUA, visual analog scale (VAS) of pain, VAS global activity assessment, swollen and tender joint counts, and a cumulative measure of tophi. Alternative scores were also developed. The developed GAS demonstrated a good correlation with functional disability (criterion validity) and discrimination between patient‐ and physician‐reported measures of active disease (construct validity). The results were reproduced in the external sample. Conclusion: This study developed and validated a composite measure of disease activity in gout. Further testing is required to confirm its generalizability, responsiveness, and usefulness in assisting with clinical decisions.