Rheumatology ·
Smartphone-Supported Gout Care Improves Urate Target Attainment in Trial
In a 12-month, single-center randomized trial of 280 men with gout, a physician-supervised smartphone-enabled treat-to-target model improved serum urate target attainment versus usual care. Gout flares were also less frequent, but the model’s generalizability and cost-effectiveness remain uncertain.
- 85% reached the urate target with app-led care versus 48.6% with usual care.
- Fewer gout flares were reported in the app-led group.
- Trial enrolled men at one center; wider applicability is uncertain.
This 12-month, open-label, superiority randomized controlled trial enrolled 280 men with gout at a single center. Participants were assigned to usual care or the 1CARE integrated digital model, which combined behavioral reminders, tiered education, remote serum urate monitoring and weekly physician review. The primary outcome was serum urate below 360 μmol/L; secondary outcomes included gout flares and metabolic measures.
At 12 months, 119 of 140 participants (85.0%) in the app-led group reached the urate target, compared with 68 of 140 (48.6%) receiving usual care (risk ratio 1.75; 95% CI 1.46–2.10; P<0.0001). Annualized flare frequency was 0.02 versus 0.10 per year (P<0.01). The digital-care group also had greater reductions in fasting glucose, HbA1c, total cholesterol and LDL cholesterol; medication adherence was higher. Adverse event rates were comparable.
The findings support further evaluation of digitally supported, physician-supervised treat-to-target care, but do not establish its performance beyond this single-center study of men. The authors note that multicenter trials are needed to assess generalizability, cost-effectiveness and the optimal model configuration.
In practice
For men with gout in this single-center trial, a smartphone-enabled, physician-supervised treat-to-target model increased the proportion reaching serum urate below 360 μmol/L and was associated with fewer flares over 12 months compared with usual care. The results support further testing of this care approach, but do not establish that it should replace usual management: the trial was open-label, included only men at one center, and the authors call for multicenter assessment of generalizability, cost-effectiveness and model configuration.
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Arthritis & Rheumatology: Effects of a Smartphone‐Enabled, Physician‐Supervised Treat‐to‐Target Model for Gout Management: A 12‐Month Randomized Controlled Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.