Early urate-lowering therapy in gouty arthritis with acute flares: a double-blind placebo controlled clinical trial

European Journal of Medical Research

Research

James Cheng-Chung Wei¹  Deng-Ho Yang²  Hsiang-Cheng Chen³ 

[1] Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan;Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan;Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, No 348, Sec. 2, Chung-Shan Rd, Taiping Dist., 41152, Taichung, Taiwan;Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan;Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;Institute of Biomedical Science, National Chung-Hsing University, Taichung, Taiwan;Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;

关键词: Gout;    Gouty arthritis;    Uric acid;    Probenecid;    Urate-lowering therapy;   

DOI  :  10.1186/s40001-022-00982-8

 received in 2022-07-31, accepted in 2022-12-30,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundGouty arthritis (GA) is a chronic systemic disease with recurrent acute monoarthritis. In a previous study, a higher incidence of acute flares was observed during the initial marked decrease in serum urate level. Our study evaluated the effect of early urate-lowering therapy in patients with acute GA flares.MethodsThis study included 40 patients with acute GA; of them, 20 received colchicine 0.5 mg colchicine twice daily, while 20 received probenecid 500 mg and colchicine 0.5 mg twice daily. We evaluated GA severity and laboratory data for 2 weeks after the initial therapy. Medians and interquartile ranges (IQRs) were calculated to evaluate clinical presentations between these two groups.ResultsRapidly decreasing median serum uric acid levels was found in the patients treated with probenecid and colchicine compared with the patients treated with colchicine alone on day 8 (− 1.9 [IQR, − 3.7 to 0] vs 0.8 [IQR, − 0.1–2.2]; P < 0.001). However, the median decrease in visual analog scale score did not differ significantly between the two groups (− 5.5 [IQR, − 8.0 to − 3.0] vs − 3.5 [IQR, − 5.9 to − 2.0]; P = 0.080).ConclusionNo significant increase was noted in acute gout flare severity or duration among GA patients treated with early aggressive control of hyperuricemia using probenecid plus colchicine.

【 授权许可】

CC BY   
© The Author(s) 2023

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