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Purpose: HRQOL was assessed in 2 gout populations using Short Form-36 (SF-36). Results were compared with age and gender matched US norms, patients with osteoarthritis and hypertension (OA/HTN)1 and published values from randomized controlled trials (RCTs) in rheumatoid arthritis (RA)2 and systemic lupus (SLE)3.
Methods: A 12-month observational study enrolled 110 patients with Refractory-Gout and ≥1 of the following: ≥3 flares/year, chronic synovitis/arthropathy, or tophi, with SF-36 at baseline (BL) and bi-monthly.4 A survey of VA-Gout included demographics, ICD-9 codes for: gout; arthritic and medical comorbidities; and SF-36V.5
Results: Refractory-Gout patients were 81.8% male; 68.2% Caucasian; 20% African-American; mean age 59; 65% had 3-6 flares; 21%: >6 flares/year; and 70% had tophi. Comorbidities included: HTN: 71%; OA: 42%; renal dysfunction/lithiasis: 49%; diabetes: 14%. From the VA dataset, 1,090 (2.7%) had an ICD-9 diagnosis for gout; were 99% male, 97% Caucasian; mean age, 68 years; mean (standard deviation) 1.5 (1.1) medical and 0.6 (0.9) arthritic comorbidities. Medical or arthritic comorbidities predicted clinically/statistically lower adjusted scores in all SF-36 domain and physical component summary (PCS) scores. HRQOL was poor and similar in both gout populations. Refractory-Gout and VA-Gout patients reported lower mean scores than age/gender matched norms or subjects with OA/HTN (Table). These decrements were similar to those reported in RCTs in patients with longstanding RA and active SLE (Table).
Conclusions: Gout patients can have severe disease that adversely affects their HRQOL. Reported SF-36 scores were low, and similar in Refractory-Gout and VA-Gout populations; much lower than age/gender norms or subjects with OA/HTN and comparable to those in patients with longstanding RA and active SLE. These data underscore the need for effective treatment of gout.
references:
1. Ware JE Jr.et al. SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA; 1993.
2 Strand V et al Am J Managed Care 2007; 13:S237-S251.
3 Strand V et al Ann Rheum Ds 2007; 66:SII:482
4 Sundy JS et al: Ann Rheum Ds 2007; 66: SII:
5 Singh JA et al Ann Rheum Dis 2008; 67: doi:10.1136/ard.2007.081604
Methods: A 12-month observational study enrolled 110 patients with Refractory-Gout and ≥1 of the following: ≥3 flares/year, chronic synovitis/arthropathy, or tophi, with SF-36 at baseline (BL) and bi-monthly.4 A survey of VA-Gout included demographics, ICD-9 codes for: gout; arthritic and medical comorbidities; and SF-36V.5
Results: Refractory-Gout patients were 81.8% male; 68.2% Caucasian; 20% African-American; mean age 59; 65% had 3-6 flares; 21%: >6 flares/year; and 70% had tophi. Comorbidities included: HTN: 71%; OA: 42%; renal dysfunction/lithiasis: 49%; diabetes: 14%. From the VA dataset, 1,090 (2.7%) had an ICD-9 diagnosis for gout; were 99% male, 97% Caucasian; mean age, 68 years; mean (standard deviation) 1.5 (1.1) medical and 0.6 (0.9) arthritic comorbidities. Medical or arthritic comorbidities predicted clinically/statistically lower adjusted scores in all SF-36 domain and physical component summary (PCS) scores. HRQOL was poor and similar in both gout populations. Refractory-Gout and VA-Gout patients reported lower mean scores than age/gender matched norms or subjects with OA/HTN (Table). These decrements were similar to those reported in RCTs in patients with longstanding RA and active SLE (Table).
Conclusions: Gout patients can have severe disease that adversely affects their HRQOL. Reported SF-36 scores were low, and similar in Refractory-Gout and VA-Gout populations; much lower than age/gender norms or subjects with OA/HTN and comparable to those in patients with longstanding RA and active SLE. These data underscore the need for effective treatment of gout.
| Chronic Conditions | Physical Function | Role Physical | Bodily Pain | General Health | Vitality |
| Refractory-Gout | 46.8 | 35 | 45.6 | 42.6 | 45 |
| VA-Gout | 43.6 | 42.9 | 44 | 46.4 | 42 |
| Age-gender-matched U.S. norms (ref 1) | 70.3 | 65.1 | 69.3 | 61.5 | 59.2 |
| U.S norms for Osteoarthritis (OA) and Hypertension (age 65-74, ref 1) | 57.4 | 38.2 | 55.4 | 59 | 49.5. |
| Rheumatoid Arthritis (ref 2) | 26.2-57.4 | 10.7-49.7 | 30.0-50.0 | 34.9-59.0 | 31.0-49.5 |
| Systemic Lupus Erythematosus (ref 3) | 53.5-66.5 | 44.8-57.7 | 46.9-64.3 | 37.3-48.2 | 37.6-49.8 |
references:
1. Ware JE Jr.et al. SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA; 1993.
2 Strand V et al Am J Managed Care 2007; 13:S237-S251.
3 Strand V et al Ann Rheum Ds 2007; 66:SII:482
4 Sundy JS et al: Ann Rheum Ds 2007; 66: SII:
5 Singh JA et al Ann Rheum Dis 2008; 67: doi:10.1136/ard.2007.081604
V. Strand, Abbott; Almirall; Allergan; AlPharma; Bayhill; Bexel; BiogenIdec; Can-Fite; Centocor; Chelsea; Cypress; Dianippon Sumitomo; EuroDiagnostica; FibroGen; Forest; Genelabs; Genentech; Human Genome Sciences; Incyte; Jazz; Lexicon Genetics; Lux Biosciences; Merck Serono; Novartis; NovoNordisk; Noxxon; Ono; Pfizer; Proctor and Gamble; Proprius; Rigel; Roche; Sanofi-Aventis; Savient; Schering Plough; Scios; SKK; UCB; VLST; Wyeth; XDx; Zelos; Amgen; J.A. Singh, TAP pharmaceuticals, 2; Abbott Labs, 8; J. Sundy, Savient, 2; H.R. Schumacher, TAP, Savient, 2; M. Becker, TAP, Savient, 5; N.L. Edwards, TAP, Savient, 2.