Considerations for Choosing First-Line Urate-Lowering Treatment in Older Patients with Comorbid Conditions

Kang, Eun Ha

doi:10.1007/s40266-022-00986-3

Cited by 2 publications

(3 citation statements)

References 66 publications

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“…Lowdose febuxostat is more suitable for older patients with a high prevalence of comorbidities. 24 Baseline BMI and sUA 14,23,25 which is consistent with our results. A higher serum urate level reflects a higher total urate burden, thereby requiring a higher dose to achieve the target serum urate.…”

Section: Discussionsupporting

confidence: 92%

Predictors of Inadequate Serum Urate Response to Low-Dose Febuxostat in Male Patients with Gout

Sun,

Zhao,

Dalbeth

et al. 2024

JIR

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This study aimed to understand predictors of inadequate response (IR) to low-dose febuxostat treatment based on clinical variables. Methods: We pooled data from 340 patients of an observational cohort and two clinical trials who received febuxostat 20 mg/day for at least 3 months. IR was defined as failure to reach the target serum urate level (sUA<6 mg/dL) at any time point during 3 months treatment. The potential predictors associated with short-or mid-term febuxostat IR after pooling the three cohorts were explored using mixed-effect logistic analysis. Machine learning models were performed to evaluate the predictors for IR using the pooled data as the discovery set and validated in an external test set. Results: Of the 340 patients, 68.9% and 51.8% were non-responders to low-dose febuxostat during short-and mid-term follow-up, respectively. Serum urate and triglyceride (TG) levels were significantly associated with febuxostat IR, but were also selected as significant features by LASSO analysis combined with age, BMI, and C-reactive protein (CRP). These five features in combination, using the best-performing stochastic gradient descent classifier, achieved an area under the receiver operating characteristic curve of 0.873 (95% CI [0.763, 0.942]) and 0.706 (95% CI [0.636, 0.727]) in the internal and external test sets, respectively, to predict febuxostat IR. Conclusion:Response to low-dose febuxostat is associated with early sUA improvement in individual patients, as well as patient age, BMI, and levels of TG and CRP.

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Section: Discussionsupporting

confidence: 92%

Predictors of Inadequate Serum Urate Response to Low-Dose Febuxostat in Male Patients with Gout

Sun,

Zhao,

Dalbeth

et al. 2024

JIR

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“…Furthermore, recent studies indicate the importance of keeping in mind the safety of certain gout medications on risks of comorbidity, cardiovascular safety [26] and with aging. [27] The present study has several limitations. First, as the HIRA-NPS database only includes items covered by NHI, medical service utilization in actual clinical settings may have been underestimated.…”

Section: Discussionmentioning

confidence: 83%

“…Furthermore, recent studies indicate the importance of keeping in mind the safety of certain gout medications on risks of comorbidity, cardiovascular safety [ 26 ] and with aging. [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

Trends in healthcare utilization by patients with gout: A cross-sectional study using Health Insurance Review and Assessment Service data

Kang,

Lee,

et al. 2024

Medicine

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This study aimed to analyze the distribution of gout patients and the utilization of healthcare services in South Korea to provide valuable recommendations to clinicians and policymakers. A cross-sectional study was conducted. Claims data from the Health Insurance Review and Assessment Service spanning 2010 to 2019 were utilized, and a sample of 69,680 patients was included in the study. The incidence of gout was observed to be high in male patients over the age of 40, with most patients receiving outpatient care for gout management. Nonsteroidal anti-inflammatory drugs and urate-lowering agents were the most frequently prescribed medications, with prescriptions for colchicine and febuxostat increasing among urate-lowering agents. Musculoskeletal disorders were found to be the most common comorbidities among gout patients. Although the total costs of gout management increased, there was no significant increase in cost per patient. This study provides insights into the current state of healthcare utilization for gout patients in South Korea and trends in the disease burden and use of medications. The findings have crucial implications for clinicians and policymakers involved in decision-making regarding the management and treatment of gout.

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Considerations for Choosing First-Line Urate-Lowering Treatment in Older Patients with Comorbid Conditions

Cited by 2 publications

References 66 publications

Predictors of Inadequate Serum Urate Response to Low-Dose Febuxostat in Male Patients with Gout

Predictors of Inadequate Serum Urate Response to Low-Dose Febuxostat in Male Patients with Gout

Trends in healthcare utilization by patients with gout: A cross-sectional study using Health Insurance Review and Assessment Service data

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