OP0167 ULTRASONOGRAPHY IN THE PREDICTION OF GOUT FLARES: A 12-MONTH PROSPECTIVE OBSERVATIONAL STUDY

Background Gout flares are a distinctive feature of gout. Although imaging techniques, such as ultrasonography (US), can visualise monosodium urate (MSU) crystals and synovial inflammation estimate their burden, the role in predicting gout has not been fully investigated. Objectives To evaluate whether US findings indicative MSU deposits subclinical predict over 12 months. Methods Participants with on urate-lowering therapy (ULT) for at least preceding six months were enrolled consecutively this 12-month prospective, observational, single-centre study. A nested case-control analysis was performed. Cases participants one flare follow-up period while controls did self-report any flares. Clinical assessment scheduled 6-month intervals. In addition, baseline, each patient underwent an examination using standardised scanning protocol including following sites: knees, ankles, 1 st metatarsophalangeal joints, elbows, wrists 2 nd metacarpophalangeal joints. The indicating [i.e., aggregates, double contour (DC) sign tophi] Power Doppler (PD) signal] identified according to 2015 Outcome Measure Rheumatology definitions (Figure 1). Figure 1. Summated scores calculated finding. During visits, patients asked report internationally-validated definition [1]. Multivariate logistic regression used measure association between baseline occurrence tested separately, covariates: age, gender, disease duration, presence subcutaneous tophi, current serum urate>360 μmol/l, increasing dose ULT during study ongoing prophylaxis. multivariate zero-inflated Poisson investigate number Results Eighty-one enrolled, 71 completed Thirty (42.3%) experienced months, median 2.0 There no difference among clinical laboratory characteristics without except tophi (23.3% vs 4.9%; p=0.02) higher SU levels (360.8 301.4 μmol/l mol/L, p=0.01). had greater burden (2.0±1.8 0.5±0.9, p=0.01 DC sign; 2.1±2.3 0.8±1.0, tophi; 2.6±2.0 1.6±1.6, p=0.03 aggregates) (3.73±3.53 0.82±1.44, p<0.01). extent estimated by significantly associated analyses. score (aOR: 2.20, 95%CI: 1.22-4.34; p=0.01), 2.16, 1.12-4.18; PD 1.63, 1.12-2.40; p=0.01) predicted flares, whereas aggregates 1.40, 0.94-2.10; p=0.10) reach statistical significance. Similar results obtained models (aIRR score: 1.39, 1.18-1.64, p<0.01, aIRR 1.30, 1.17-1.45, 1.29, 1.19-1.40, 1.13, 1.00-1.29, p=0.05). Conclusion Baseline independent predictors References [1]Gaffo AL, et al. Brief Report: Validation Definition Flare Patients With Established Gout. Arthritis Rheumatol. 2018;70:462-7. Disclosure Interests None declared