Factors Associated With Intermittent and Constant Pain Patterns in People With Gout: A Cross-Sectional Analysis

Although gout is traditionally conceptualized as an episodic disease characterized by acute flares and symptom-free intercritical periods, some individuals report persistent joint pain that extends beyond flares. This cross-sectional analysis aimed to explore factors associated with self-reported pain patterns (constant vs intermittent) in people with gout.

This cross-sectional analysis was performed on data from 90 participants with physician-diagnosed gout who completed clinical assessments and patient-reported outcome measures. Pain patterns were classified using participant-selected validated graphical representations representing intermittent and constant pain patterns. Multivariable logistic regression was used to identify factors independently associated with constant pain. Model discrimination was assessed using the area under the receiver operating characteristic curve (ROC AUC).

One-third of participants (34.4%) reported a constant pain pattern. The final regression model indicated that constant pain was independently associated with younger age of gout onset (adjusted odds ratio [aOR] 0.86, 95% confidence interval [CI] 0.79-0.93), greater activity limitation (aOR 5.75, 95% CI 1.43-23.01), and current co-existing anxiety or depression (aOR 9.21, 95% CI 1.39-60.91). The regression model demonstrated good discrimination between participants with constant and intermittent pain patterns with an ROC AUC of 0.82 (95% CI 0.73-0.91).

A substantial proportion of people with gout experience constant pain, which is linked to early disease onset, functional impairment, and mood disturbance. These hypothesis-generating findings suggest that the model of pain-free intercritical gout may not apply to all people with gout and may emphasize the need for tailored management strategies for people with gout.