Stewart S, et al. - Authors ascertained the clinical factors related to activity limitation and predictors of a change in activity limitation after 1 year in people with gout. A wide range of activity limitation was experienced by people with gout. The levels of activity limitation were, on average, stable over a 1-year period. Experts noted a strong association of baseline pain scores with activity limitation. These scores predicted development of activity limitation in those with normal Health Assessment Questionnaire-II (HAQ-II) scores at baseline.

Methods

• A baseline assessment which included medical and disease-specific history, pain visual analog score and plain radiographs scored for erosion and narrowing was attended by 295 participants with gout (disease duration < 10 years).
• Using the Health Assessment Questionnaire-II (HAQ-II) authors assessed the activity limitation.
• They invited the participants to complete a further HAQ-II after 1 year; follow-up questionnaires were available for 182 participants.
• In order to determine associations between baseline characteristics and HAQ-II at baseline and 1 year, and to determine predictors of worsening HAQ-II in those with normal baseline scores, fully saturated and stepwise regression analyses were used.

Results

• As per the data, median (range) baseline HAQ-II was 0.20 (0–2.50) and 0.20 (0–2.80) after 1 year of follow-up.
• Findings suggested that pain score was the strongest independent predictor of baseline HAQ-II, followed by radiographic narrowing score, type 2 diabetes, swollen joint count, BMI, age and urate (model R²=0.51, P < 0.001).
• In HAQ-II at 1 year, baseline HAQ-II was the strongest predictor of change followed by tender joint count (model R²=0.19,P < 0.001).
• Researchers noted that out of those with HAQ-II scores of 0 at baseline (n=59, 32% of those with follow-up data), most did not progress (n=52, 88%).
• Nonetheless, significant predictors of worsening HAQ-II in this group were baseline pain score, type 2 diabetes and flare frequency (R²=0.34,P < 0.001).