BACKGROUND/AIMS: Radiographic damage is frequently observed in patients with longstanding gout. The aim of this prospective observational study was to determine factors associated with change in radiographic damage scores in gout. METHODS: People with gout and disease duration <10 years were recruited into this prospective observational study. At the baseline visit, structured assessment was undertaken in 290 participants including detailed clinical examination and plain radiographs (XR) of the hands and feet. Participants were invited to attend a further study visit with repeat XR 3 years after the baseline visit. XR were scored for erosion and joint space narrowing according to the gout-modified Sharp/van der Heijde XR damage score. RESULTS: Age, subcutaneous tophus count and tender joint count were independently associated with XR damage score at the baseline visit. Paired serial XR were available for 140 participants. In stepwise linear regression analysis, change in total damage score over 3 years was positively associated with change in subcutaneous tophus count and baseline XR damage score, and inversely associated with baseline subcutaneous tophus count (model R2=0.39, p<0.001). Change in subcutaneous tophus count contributed most to the change in erosion score (partial R2 change=0.31, p<0.001), and baseline XR damage score contributed most to the change in narrowing score (partial R2 change=0.31, p<0.001). CONCLUSIONS: Development of new subcutaneous tophi and baseline radiographic damage are associated with progressive joint damage scores in people with gout. These data provide further evidence that the tophus plays a central role in bone erosion in gout. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND/AIMS: Radiographic damage is frequently observed in patients with longstanding gout. The aim of this prospective observational study was to determine factors associated with change in radiographic damage scores in gout. METHODS:People with gout and disease duration <10 years were recruited into this prospective observational study. At the baseline visit, structured assessment was undertaken in 290 participants including detailed clinical examination and plain radiographs (XR) of the hands and feet. Participants were invited to attend a further study visit with repeat XR 3 years after the baseline visit. XR were scored for erosion and joint space narrowing according to the gout-modified Sharp/van der Heijde XR damage score. RESULTS: Age, subcutaneous tophus count and tender joint count were independently associated with XR damage score at the baseline visit. Paired serial XR were available for 140 participants. In stepwise linear regression analysis, change in total damage score over 3 years was positively associated with change in subcutaneous tophus count and baseline XR damage score, and inversely associated with baseline subcutaneous tophus count (model R2=0.39, p<0.001). Change in subcutaneous tophus count contributed most to the change in erosion score (partial R2 change=0.31, p<0.001), and baseline XR damage score contributed most to the change in narrowing score (partial R2 change=0.31, p<0.001). CONCLUSIONS: Development of new subcutaneous tophi and baseline radiographic damage are associated with progressive joint damage scores in people with gout. These data provide further evidence that the tophus plays a central role in bone erosion in gout. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Tomas Cazenave; Victoria Martire; Anthony M Reginato; Marwin Gutierrez; Christian Alfredo Waimann; Carlos Pineda; Javier Eduardo Rosa; Santiago Ruta; Oscar Sedano-Santiago; Ana Maria Bertoli; Marcelo Audisio; Cristina Hernandez-Diaz; Lucio Ventura-Rios; Maritza Quintero; Eugenio De Miguel; Ana Laura Alvarez-Del-Castillo-Araujo; Andy Abril; Eliana Natalí Ayala-Ledesma; Edith Alarcon-Isidro; Maria Lida Santiago; Mariana Alejandra Pera; Cecilia Urquiola; Gustavo Rodriguez Gil; Lina Maria Saldarriaga Rivera; Cesar Cefferino; Mariana Benegas; Mario Enrique Diaz Cortes; Maximiliano Bravo; Diana Peiteado; Natalia Anahi Estrella; Roser Areny Micas; Jorge Saavedra Muñoz; Rodolfo Del Carmen Arape Toyo; Maria Soledad Gálvez Elkin; Walter Javier Spindler; Clarisa Sandobal; Josefina Marin; Manuella Lima Gomes Ochtrop; Ricardo Pavao Ayala; Erika Roxana Catay; Guillermo Enrique Py; Gabriel Hector Aguilar; Yvonne Yona Rengel Colina; Carla Antonela Airoldi; Claudia Selene Mora-Trujillo; Maria Paula Kohan; Lorena Evelin Urioste Eguez; Concepción Castillo-Gallego; Jose Francisco Diaz-Coto; Patricio Tate; Carla Magali Saucedo; Oscar Vega-Hinojosa; Cristian Jonatan Troitiño; Maria Florencia Marengo; Priscila Maria Marcaida; Irene Monjo Henry; Roberto Muñoz-Louis; Carla Solano; Felix Reinaldo Fernandez Castillo; Cesar Enrique Graf; Mara Guinsburg; Maria Julia Santa Cruz; David Alejandro Navarta Ortiz; Magaly Alva Linares; Marcos Gabriel Rosemffet Journal: Rheumatol Int Date: 2018-12-11 Impact factor: 2.631
Authors: Nicola Dalbeth; Kenneth G Saag; William E Palmer; Hyon K Choi; Barbara Hunt; Patricia A MacDonald; Ulrich Thienel; Lhanoo Gunawardhana Journal: Arthritis Rheumatol Date: 2017-12 Impact factor: 10.995