POS1125 DUAL ENERGY CT HAS PROGNOSTIC VALUE IN GOUT BEYOND STANDARD CLINICAL MEASURES: A BEST EVIDENCE SYNTHESIS

Background: Dual Energy CT Scan (DECT) can detect monosodium urate crystal deposits in multiple tissues. EULAR gout guidelines (Richette, 2020) recognized the value of DECT making a clinical diagnosis when joint aspiration is difficult. shows almost 50% patients without tophi (Dalbeth, 2017). Tophi are known to predict all-cause and cardiovascular mortality (Vincent 2017, Perez-Ruiz 2013) it plausible that could as well. A prognostic measure should be reliable valid. validity would evident for death, disability distress. Objectives: This study used best evidence synthesis approach synthesize gout. Methods: PUBMED EMBASE were searched from initiation December 2019; keywords (Dual Computed Tomography OR DECT, gout, tophaceous chronic crystals burden volume flares pain distress death function). Human studies English considered. Titles, abstracts full articles reviewed. manual search secondary sources was conducted. Key gaps identified considered throughout 2020 reviewing emerging presentations. Data extraction conducted by both authors; data presented represents consensus. Results: Of 344 articles, 81 titles/abstracts met screening inclusion criteria (24%) 2019 search; review manuscript led 41 selected (51%). Additionally, 3 key papers 2 ACR presentations through 2020. highly with inter-class correlation coefficients >0.9. has content validity. Dalbeth (2015) showed X-Rays findings correlated patients, r=0.70, p<0.001. Hand function correlates burden, r =0.59, p=0.024 (Dalbeth 2007). (2017) associated greater at 12 months (p<0.01) 152 patients. Pascart (2018) confirmed subjects had nearly doubled feet volumes (0.9 vs 2.1 cm , p=0.05) versus those not flaring. abnormal scans occurred 47% normal uric acid (<6.0 mg/dL) palpable 90% elevated tophi. very sensitive change (Araujo 2015) 95% reduction on pegloticase treated up months. Three show risk factor prevalence (Pascart 2020, Gamala 2018, Lee Marty-Ané reported predicts (Marty-Ané 2020). Limited suggests minimum important 1.0 ankles, including Conclusion: imaging reliable, change. appears future flares, mortality. Minimum approximates . requires further but relevant outcome trials staging References: Authors Journal, Volume, Issue Year Araujo, E. G., Bayat, S., et al. RMD Open 2015 Dalbeth, N., Nicolaou, Ann Rheum Dis 77(3) 2017 Aati, O., 74(6) Collis, J., Rheumatology 46(12) 2007 Gamala, M., Linn-Rasker, S. P., Clinical Rheumatol 37(7) 2018 Lee, K., Ryu, Rheumatol, 37 Marty-Ané, A., Norberciak, L., Arthritis 72 (supp 10) [abstract #0954] Pascart, T., Ramon, J Clin Med, 9(5) Capon, B., Res Therapy 20(1) Perez-Ruiz, F., Martínez-Indart, Dis, 73(1) 2013 Richette, Doherty, 79(1) Vincent, Z., Gamble, 44 (3) Disclosure Interests: Sally Stauder: None declared, Paul M. Peloso Shareholder of: Horizon Therapeutics plc, Employee plc.