With increased interest in gout and the advent of better management opportunities more attention has been paid to defining relevant outcomes in gout, also for use in clinical practice.
International guidelines advocate treatment to below a threshold of 360 μmol/l (6 mg/dl) and below 300 μmol/l (5 mg/dl) if a patient has tophi. While this is the target for treatment, other outcome domains have been developed as part of OMERACT work.
Identified outcomes for acute gout include mandatory core outcomes: pain, joint swelling, joint tenderness, patient global assessment of disease activity, and activity limitations. In addition there are additional domains for assessment which include: an acute phase marker of inflammation, work disability, joint impairment, joint erythema, and physician global assessment of disease activity.
Many different instruments have been used to assess the acute gout core domains. In order to reduce existing variation, standardisation of measuring the most important domains of gout is recommended.
In clinical practice flares indicate a failure of ongoing treatment of gout. On the other hand the development of a responder index is an area of investigation as is the definition of remission in gout. Ongoing research tries to define a time period in which a flare needs to be absent so the patient can be defined as in remission.
Disclosure of Interest None declared