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de Lautour H, Taylor WJ, Adebajo A, Alten R, Burgos-Vargas R, Chapman P, Cimmino MA, da Rocha Castelar Pinheiro G, Day R, Harrold LR, Helliwell P, Janssen M, Kerr G, Kavanaugh A, Khanna D, Khanna PP, Lin C, Louthrenoo W, McCarthy G, Vazquez-Mellado J, Mikuls TR, Neogi T, Ogdie A, Perez-Ruiz F, Schlesinger N, Ralph Schumacher H, Scirè CA, Singh JA, Sivera F, Slot O, Stamp LK, Tausche AK, Terkeltaub R, Uhlig T, van de Laar M, White D, Yamanaka H, Zeng X, Dalbeth N. Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises. Arthritis Care Res (Hoboken) 2017; 68:667-72. [PMID: 26414176 DOI: 10.1002/acr.22741] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 09/09/2015] [Accepted: 09/22/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To establish consensus for potential remission criteria to use in clinical trials of gout. METHODS Experts (n = 88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey, followed by a discrete-choice experiment using 1000Minds software. The exercises focused on identifying domains, definitions for each domain, and the timeframe over which remission should be defined. RESULTS There were 49 respondents (56% response) to the initial survey, with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%), and patient global assessment of disease activity (93%) as measurement domains in remission criteria. Consensus was also reached for domain definitions, including serum urate (<0.36 mm), pain (<2 on a 10-point scale), and patient global assessment (<2 on a 10-point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission, with equal responses for 6 months (51%) and 1 year (49%). In the discrete-choice experiment, there was a preference towards 12 months as a timeframe for remission. CONCLUSION These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain, and patient global assessment. These preliminary criteria now require testing in clinical data sets.
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Affiliation(s)
| | | | | | - Rieke Alten
- Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany
| | | | | | | | | | - Ric Day
- University of New South Wales and St Vincent's Hospital, Sydney, Australia
| | - Leslie R Harrold
- University of Massachusetts Medical School, Worcester, and Corrona, LLC, Southborough
| | - Philip Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
| | | | - Gail Kerr
- Veterans Affairs Medical Center, Georgetown and Howard University Hospitals, Washington, DC
| | | | | | - Puja P Khanna
- University of Michigan and Ann Arbor VA Medical Center, Ann Arbor
| | - Chingtsai Lin
- Taichung Veteran's General Hospital, Taichung, Taiwan
| | | | - Geraldine McCarthy
- Mater Misericordiae University Hospital and University College, Dublin, Ireland
| | | | - Ted R Mikuls
- Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Fernando Perez-Ruiz
- Hospital Universitario Cruces, OSI-EEC, and Biocruces Health Research Institute, Biscay, Spain
| | - Naomi Schlesinger
- Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Carlo A Scirè
- IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Jasvinder A Singh
- University of Alabama at Birmingham and the Birmingham VA Medical Center, Birmingham
| | | | - Ole Slot
- Copenhagen University Hospital Glostrup, Glostrup, Denmark
| | | | | | | | - Till Uhlig
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Douglas White
- Waikato DHB and Waikato Clinical School, University of Auckland, Hamilton, New Zealand
| | | | - Xuejun Zeng
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Nicola Dalbeth
- University of Auckland and Auckland District Health Board, Auckland, New Zealand
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