What’s new on the front-line of gout pharmacotherapy?

Blake, Karl E.; Saag, Jordan L.

doi:10.1080/14656566.2021.2020249

Cited by 7 publications

(3 citation statements)

References 88 publications

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“…A previous animal study demonstrated a positive correlation between the blood flow signal in the synovium and the tissue vascularization measured by CD31 immunohistochemistry [32], suggesting the role of inflammation in mediating high blood flow signals. Similarly, it is reasonable to hypothesize that vasodilation and congestion caused by activation of inflammatory mediators [33] associated with gout flares may lead to the elevation of blood flow, which was further supported by the effectiveness of anti-inflammatory treatments [34].…”

Section: Discussionmentioning

confidence: 93%

The usefulness of ultrasound in identifying the underlying findings linked to pain in podagra patients

Du,

Zhong,

Yan

et al. 2024

Med Ultrason

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Aim: To explore whether ultrasound (US) can be employed to identify the underlying characteristics associated with pain in patients with podagra by evaluating the relationship between ultrasound findings and clinical pain.Material and methods: Patients with podagra were recruited and grouped into a pain group (G1, 82 patients) and a non pain group (G2, 123 patients). US features were collected and compared. US data were analyzed by binary logistic regression analysis and ROC analysis. Interobserver reliability was assessed, too.Results: A total of 205 patients (196 male and 9 female) were enrolled in this study. In multivariate analysis, the thickness of the synovium (OR=1.928, CI=1.074-3.463), CD (color Doppler) signal of the synovium (OR=1.458, CI=1.011-2.103), and CD signal of the tophi (OR=1.576, CI=1.142-2.177) were identified as risk factors for clinical pain. Areas under the ROC curves (AUC) were 0.713, 0.686 and 0.641 for the three indicators, respectively. The best cutoff points were 1 mm for the thickness of the synovium, grade 1 for the CD signal of the synovium and grade 2 for the CD signal of the tophi.Conclusions: Ultrasound can provide valuable information for determining underlying features associated with pain in patients with podagra.

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Section: Discussionmentioning

confidence: 93%

The usefulness of ultrasound in identifying the underlying findings linked to pain in podagra patients

Du,

Zhong,

Yan

et al. 2024

Med Ultrason

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“…Current guidelines developed by the American College of Rheumatology (ACR) and EULAR strongly recommend the use of treat-to-target urate-lowering therapy for gout (13,16). Approved pharmacologic urate-lowering therapy options can reduce urate production (xanthine oxidase inhibitors), enhance urinary excretion of urate (uricosuric agents), or for more severe disease, degrade urate in the blood (uricases) (1,4,8,9,17,18). Xanthine oxidase inhibitors are the current standard for uratelowering therapy in patients, including those with moderate-tosevere chronic kidney disease (16).…”

Section: Introductionmentioning

confidence: 99%

Serum Urate–Lowering Efficacy and Safety of Tigulixostat in Gout Patients With Hyperuricemia: A Randomized, Double‐Blind, Placebo‐Controlled, Dose‐Finding Trial

Terkeltaub

Lee

Min

et al. 2023

Arthritis & Rheumatology

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Objective. To evaluate the safety and efficacy of the nonpurine xanthine oxidase inhibitor tigulixostat for lowering serum urate level in gout patients with hyperuricemia.Methods. We conducted a multicenter, phase II, randomized, double-blind, placebo-controlled, parallel-group, dose-finding trial. After screening, gout patients with hyperuricemia were randomly assigned, after appropriate washout, to receive daily oral administration of 50 mg, 100 mg, or 200 mg of tigulixostat, or placebo for 12 weeks. Colchicine gout flare prophylaxis was administered to all patients. The primary end point was the proportion of patients with a serum urate level <5.0 mg/dl at week 12.Results. A total of 143 patients were randomized to receive tigulixostat 50 mg (n = 34), 100 mg (n = 38), or 200 mg (n = 37), or placebo (n = 34). A significantly greater proportion of patients in the tigulixostat groups achieved the target serum urate level <5.0 mg/dl at week 12 (47.1% in the 50 mg group, 44.7% in the 100 mg group, and 62.2% in the 200 mg group) compared to the placebo group (2.9%) (P < 0.0001). The mean percentage change in serum urate level from baseline was also significantly greater in the tigulixostat groups (−38.8% to −61.8%) than in the placebo group at all time points (P < 0.0001). The rate of gout flares requiring rescue treatment ranged from 9.4% to 13.2% in the tigulixostat and placebo groups. The incidence of adverse events was 50.0% to 56.8% across all groups, and their severity was mild or moderate.Conclusion. Tigulixostat significantly lowered serum urate compared to placebo at all doses studied with an acceptable safety profile.ClinicalTrials.gov identifier: NCT03934099.

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“…Although colchicine can alleviate the patient's condition in a short time, there will be different adverse reactions such as damage to the liver, kidney, gastrointestinal, and bone marrow suppression after the treatment [ 6 ]. NSAIDs can also effectively reduce joint pain, but they are lack in reducing serum uric acid level with certain side effects [ 7 ]. Hence, it is important to seek a safe and effective treatment method.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Qinpi Tongfeng Formula in the Treatment of Acute Gouty Arthritis: A Double-Blind, Double-Dummy, Multicenter, Randomized Controlled Trial

Fan

Liu

Lü

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Traditional Chinese medicine (TCM) has certain curative effect against acute gouty arthritis (AGA), but it lacks high-quality evidence-based studies. In this randomized controlled trial, we try to evaluate the clinical efficacy and safety of Qinpi Tongfeng Formula (QPTFF) in the treatment of AGA. Methods. One hundred and fourteen patients with AGA (damp heat accumulation syndrome) who met the inclusion and exclusion criteria were randomly divided into treatment group and control group in a ratio of 1 : 1. Patients in the treatment group were treated with QPTFF, and patients in the control group were treated with diclofenac sodium sustained-release tablets for 7 days. The primary outcome measure was the change in visual analog scale (VAS) score for pain from the baseline to day 8. The secondary outcome measures were joint symptom score, TCM syndrome score, total effective rate, pain cure rate, complete pain relief time, patient satisfaction score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum uric acid level. The safety outcome measures were routine blood test, urinalysis, liver function including alanine aminotransferase and aspartate aminotransferase, renal function including blood urea nitrogen and serum creatinine, and the rate of treatment-related adverse events (TRAEs). Results. 105 patients with 53 in the treatment group and 52 in the control group completed the 7-day treatment. There was no significant difference between two groups in demographic characteristics, VAS score for pain, joint symptom score, TCM syndrome score, ESR, CRP, and serum uric acid level before enrollment at baseline (based on both the full analysis set (FAS) and per protocol set (PPS), P > 0.05 ). The 95% confidence interval of the difference between the eighth and first VAS score for pain of the two groups was (−0.57, 0.42) in FAS and (−0.48, 0.47) in PPS. The lower bound of both FAS and PPS is greater than the bound value of −0.7. On day 8, there was no significant difference between the two groups in joint symptom score, TCM syndrome score, total effective rate, pain cure rate, complete pain relief time, patient satisfaction score, ESR, and CRP (FAS and PPS, P > 0.05 ). The serum uric acid level and TRAEs in the treatment group were significantly lower than those in the control group (FAS and PPS, P < 0.05 ). Conclusions. QPTFF could alleviate the symptoms of patients with AGA, which is not inferior to diclofenac sodium sustained-release tablets in analgesic. Moreover, QPTFF overmatches diclofenac sodium sustained-release tablets in decreasing serum uric acid level and TRAEs. Therefore, the results provide reliable foundation for QPTTF in the treatment of AGA. Trial Registration. This study protocol was registered in Chinese Clinical Trial Registry (registration number: ChiCTR2100050638).

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What’s new on the front-line of gout pharmacotherapy?

Cited by 7 publications

References 88 publications

The usefulness of ultrasound in identifying the underlying findings linked to pain in podagra patients

The usefulness of ultrasound in identifying the underlying findings linked to pain in podagra patients

Serum Urate–Lowering Efficacy and Safety of Tigulixostat in Gout Patients With Hyperuricemia: A Randomized, Double‐Blind, Placebo‐Controlled, Dose‐Finding Trial

Efficacy and Safety of Qinpi Tongfeng Formula in the Treatment of Acute Gouty Arthritis: A Double-Blind, Double-Dummy, Multicenter, Randomized Controlled Trial

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