Chuanhu Anti-Gout Mixture versus Colchicine for Acute Gouty Arthritis: A Randomized, Double-Blind, Double-Dummy, Non-Inferiority Trial

Abstract

Background The Chuanhu anti-gout mixture has been used for many years in the treatment of gout in Chinese Traditional Medicine, and current methods for treatments for acute gouty arthritis have been either less effective or have had serious side effects.Methods In this 12-week, double-blind, double-dummy, non-inferiority study, outpatient individuals with newly diagnosed acute gouty arthritis were randomly assigned to receive Chuanhu anti-gout mixture or colchicine. Both the study investigators and the participants were masked to the treatment assignments. The primary outcome was the recurrence rate of acute gouty arthritis, and the secondary outcomes were changes in white blood cells (WHC) and C-reactive protein (CRP). This trial is registered at ISRCTN.org as trial ISRCTN65219941.Results A total of 176 patients were randomly assigned to receive either the Chuanhu anti-gout mixture or Colchicine. The overall recurrence rates in the Chuanhu anti-gout mixture group (CH group) and the Colchicine group (Col group) were 12.50% vs 14.77% (difference -2.22%, 95% confidence interval (95% CI): -10.78%~6.23%), meeting the predefined non-inferiority criterion of 15%, as did the data for WHC and CRP. The incidence of adverse events (mainly diarrhea) was less in the Col group than in the CH group (2.27% vs 28.41%, 95% CI 0.01~0.26). In addition, changes in blood uric acid, alanine aminotransferase, aspartate aminotransferase and creatinine in the CH group were significantly larger compared to those in the Col group (P<0.05).Conclusions The Chuanhu anti-gout mixture was non-inferior to colchicine for the treatment of acute gouty arthritis. The study suggested that the Chuanhu anti-gout mixture can be considered an alternative choice for the treatment of acute gouty arthritis because of its lower incidence of adverse events and its protection of kidney and renal function.

Luteolin-rich chrysanthemum flower extract suppresses baseline serum uric acid in Japanese subjects with mild hyperuricemia

“…Nonsteroidal anti-inflammatory drugs [2], steroids [3], and colchicine [4] are prescribed to suppress acute pain and inflammation, while xanthine oxidase (XOD) inhibitors such as allopurinol are used for reduction of high blood uric acid levels [5]. Several Japanese foods have a high content of purine bases, such as nori (seaweed), shiitake (mushrooms), chicken liver, and sakura shrimp [6].…”

The Impact of Natural Product Dietary Supplements on Patients with Gout: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

“…A total of nine RCTs with 1156 participants were included in this review. Seven trials were conducted in China [20][21][22][23][24][25][26], 1 in the USA [27], and 1 in New Zealand [28]. All the studies were published from 2008 to 2019.…”

“…Two trials had unclear randomization without description in sufficient detail [23,26]. Five trials had lower risk bias for allocation concealment [21,22,24,27,28]. ree trials were doubleblinded trials with a lower risk for blinding participants and study personnel [21,22,28].…”

“…Five trials had lower risk bias for allocation concealment [21,22,24,27,28]. ree trials were doubleblinded trials with a lower risk for blinding participants and study personnel [21,22,28]. Two trials did not use a blinding method to participants and study personnel during the study with a high risk due to the great appearance difference between Chinese medical formulation pills and decoction with conventional pharmaceutics such as indomethacin, benzbromarone, and allopurinol [20,25].…”

Comparative Study on Methanolic and Chloroform Extracts of Trachyspermum Ammi Seeds for Antiarthritic and Antigout Activity.

“…Treatment with NSAIDs, steroids or colchicines improves symptoms 7 . Long-standing elevated uric acid levels (hyperuricemia) may result in other symptomatology including hard, painless deposits of uric acid crystals known as tophi 8 . Lesch-Nyhan syndrome is often associated with gouty arthritis.…”