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Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises.

Hugh de Lautour1, William J Taylor2, Ade Adebajo3

  • 1Auckland District Health Board, Auckland, New Zealand.

Arthritis Care & Research
|September 29, 2015
PubMed

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Summary

Consensus was reached on key domains for gout remission criteria, including serum urate, flares, tophi, pain, and patient assessment. These proposed criteria require further testing in clinical data to refine gout management.

Area of Science:

  • Rheumatology
  • Clinical Trial Design

Background:

  • Gout is a complex inflammatory arthritis characterized by hyperuricemia and urate crystal deposition.
  • Establishing clear remission criteria is crucial for standardizing clinical trials and evaluating treatment efficacy in gout management.

Purpose of the Study:

  • To achieve expert consensus on potential remission criteria for use in clinical trials of gout.
  • To identify key domains, their definitions, and appropriate timeframes for defining gout remission.

Main Methods:

  • A multi-round Delphi consensus exercise involving 88 gout experts.
  • A discrete-choice experiment was employed to refine the timeframe for remission.
  • Web-based questionnaires and specialized software (SurveyMonkey, 1000Minds) were utilized.

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Main Results:

  • Consensus was achieved for including serum urate, flares, tophi, pain, and patient global assessment as domains for gout remission.
  • Specific definitions were agreed upon for serum urate (<0.36 mm), pain (<2/10), and patient global assessment (<2/10).
  • While experts favored a 12-month timeframe for remission in a discrete-choice experiment, consensus was not fully reached in the Delphi exercise.

Conclusions:

  • Provisional criteria for gout remission have been established, encompassing serum urate, flares, tophi, pain, and patient global assessment.
  • These preliminary criteria require validation through testing in existing clinical datasets.
  • The identified domains and definitions provide a foundation for future gout clinical trial standardization.