{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T17:10:34Z","timestamp":1759425034590,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare outcomes of 2 gout clinics that implemented different treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients newly diagnosed with gout and a follow\u2010up of 9\u201315 months were included. Co\u2010primary outcomes were the proportion of patients reaching a serum uric acid (<jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content>) \u22640.36 mmoles\/liter and free of flares. Secondary outcomes were the proportion of patients requiring treatment intensification and experiencing adverse events. One clinic adopted a strict serum UA (\u22640.30 mmoles\/liter target) strategy, with early addition of a uricosuric to allopurinol, and the other clinic adopted a patient\u2010centered (PC) strategy emphasizing a shared decision based on serum UA and patient satisfaction with gout control. Independent <jats:italic>t<\/jats:italic>\u2010tests or chi\u2010square tests were used to test differences in outcomes, and logistic regressions were used to adjust the effect of the treatment center on outcomes for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 126 and 86 patients had a follow\u2010up mean \u00b1 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> of 11.3 \u00b1 1.8 versus 11.1 \u00b1 1.9 months. In the <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> strategy, 105 of 126 patients (83%) compared to 63 of 86 (74%) in the <jats:styled-content style=\"fixed-case\">PC<\/jats:styled-content> strategy (<jats:italic>P<\/jats:italic> = 0.10) reached the threshold of \u22640.36 mmoles\/liter; and 58 of 126 (46%) versus 31 of 86 (36%) were free of flares (<jats:italic>P<\/jats:italic> = 0.15). In the <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> strategy, 76 of 126 patients (60%) were on allopurinol monotherapy compared to 63 of 86 (73%) in the <jats:styled-content style=\"fixed-case\">PC<\/jats:styled-content> strategy (<jats:italic>P<\/jats:italic> = 0.05), yet the number of adverse events was not different (n = 25 [20%] versus n = 20 [23%]; <jats:italic>P<\/jats:italic> = 0.55). Adjusting for confounders did not substantially change these associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A strict <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> strategy resulted in a nonsignificantly higher proportion of patients reaching a serum <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> \u22640.36 mmoles\/liter and being free of flares. This result was accomplished with significantly more therapy intensification. The small sample size plays a role in the significance of results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23995","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T11:40:28Z","timestamp":1559302828000},"page":"1169-1176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative Study of Real\u2010Life Management Strategies in Gout: Data From Two Protocolized Gout Clinics"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3409-1444","authenticated-orcid":false,"given":"R.","family":"te Kampe","sequence":"first","affiliation":[{"name":"Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-9896","authenticated-orcid":false,"given":"C.","family":"van Durme","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Janssen","sequence":"additional","affiliation":[{"name":"VieCuri Medical Centre  Venlo The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"van Eijk\u2010Hustings","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"A.","family":"Boonen","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3026-3154","authenticated-orcid":false,"given":"T. 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