Sarah Stewart, PhD: Long-Term Gout Flare Prevention

Rheumatology network sat down with Sarah Stewart, PhD, to discuss her study entitled "What Represents Treatment Efficacy in Long-term Studies of Gout Flare Prevention? An Interview Study of People With Gout." Stewart is a research fellow at the University of Auckland. She explains the factors that are most associated with patient experience of gout, her interest in studying gout treatment efficacy, and the clinical significance of the results of the study.

Rheumatology Network: What initially sparked your interest in studying gout treatment efficacy over time?

Sarah Stewart, PhD: I think for this particular project, that idea came from some qualitative work that we've done. So that work showed that the patient experience of gout flares encompasses several different factors. And they're not consistently captured in long term studies. So long term studies, assessing gout-free management?

RN: And what are some of the factors that are most associated with the patient experience of gout?

SS: The ones we looked at in this particular study,were flare duration, flare frequency, and pain severity.

RN: Can you tell me a little bit about the study design and methods used?

SS: There are 3 factors that we're particularly interested in. And we wanted to know which of these were most important to patients, in particular, the way they viewed whether a treatment was working or not. So, did they receive a reduction in the duration of the gout flares over time to be indicative of treatment success? Or was it a reduction in flare frequency? Or was it pain severity? And so we undertook an interview study, where we showed the participants 3 different flare scenarios over a hypothetical 6-month period. It was mostly interview study.

RN: And what were the primary endpoints of the study?

SS: What we found was that the majority of patients perceive that a shorter flare duration was the most common indicator of treatment success. So, they would rather experience shorter flares, than flares that where maybe less painful and flares that were less frequent. And looking at the qualitative data that we also gathered as part of the study this, it seemed to be because they wanted to get the flare “over and done with,” to quote 1 patient. But other reasons behind it were flare duration was also related to the ability to work in socializing and even carrying out simple tasks around the home. And 1 other thing is that clear duration isn't routinely measured and long term studies of gout. So, these findings have quite important implications as well for the future research.

RN: What was the clinical significance of these results?

SS: And I think mostly the results are going to help us develop a more standardized way of measuring flares in long-term studies.

RN: Were there any strengths or limitations of the study that you would like to discuss?

SS: I think probably the main 1 would be that we did use a hypothetical scenario. So that wasn't actually capturing a true flare experience of the individual participants. But the scenarios were based on other studies and data were collected through flare diaries, but they weren't actually captured in real time.

RN: Does your team plan on doing any future research on this topic?

SS: Yes, we do. We are looking at developing an outcome tool at the moment. that's in ongoing research.