Prognostic factors associated with early gout flare recurrence in patients initiating urate-lowering therapy during an acute gout flare

Janssen, Carly A; Voshaar, Martijn A. H. Oude; Klooster, Peter M. ten; Vonkeman, Harald E.; Laar, Mart A F J van de

doi:10.1007/s10067-019-04566-6

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…A uric acid-lowering agent is effective for lowering serum urate levels, and reduces the rate of gout flares and tophus burden [12]. However, during the initial use of ULT, rapid reduction in serum uric acid levels can often cause flares of gout, especially in the situation of in-patients, diuretics use, surgery, and overhydration [13][14][15]. Acute gout flare is a clinically evident episode of articular or periarticular inflammation induced by monosodium urate crystals [16], causing severe pain and disability of the articular joint.…”

Section: Discussionmentioning

confidence: 99%

Combined Use of Febuxostat and Colchicine Does Not Increase Acute Hepatotoxicity in Patients with Gout: A Retrospective Study

Moon

2020

JCM

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Colchicine has been effectively used to prevent acute flares in patients with gout, but drug-related adverse events have frequently occurred. We investigated whether colchicine therapy with febuxostat is associated with hepatotoxicity in gout patients. Gout patients treated with (n = 121) or without (n = 57) colchicine were enrolled upon initiating febuxostat as a urate-lowering treatment, and clinical and laboratory data at diagnosis were compared. Logistic regression analysis was performed to evaluate the risk factors related to hepatotoxicity. Median age of the with-colchicine and without-colchicine groups was 51.0 (37.0–62.0) and 56.0 (43.5–68.5) years, respectively. During the three months of febuxostat prescription, the prevalence of hepatotoxicity was 13/121 (10.9%) in the with-colchicine group and 4/57 (7.0%) in the without-colchicine group, without statistical significance. The rate of colchicine use was not different between the study subjects with or without hepatotoxicity (76.5% vs. 67.1%, p = 0.587). Pre-existing liver disease was significantly associated with increased risk of hepatotoxicity after febuxostat treatment (odds ratio, 4.083; 95% confidence interval, 1.326–12.577; p = 0.014). Colchicine may be safely used as a prophylactic agent for gout patients with febuxostat. However, upon initiating febuxostat, it is recommended to monitor the development of acute liver injury in gout patients with underlying liver disease.

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Section: Discussionmentioning

confidence: 99%

Combined Use of Febuxostat and Colchicine Does Not Increase Acute Hepatotoxicity in Patients with Gout: A Retrospective Study

Moon

2020

JCM

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“…Early and aggressive control hyperuricemia by probenecid with colchicine could not induce higher pain severity and duration in our study. In the other study, the chronic GA patients with a serum CRP level > 3 mg/dL who did not take prophylaxis were associated with gout flare recurrence during initial ULT therapy [28].…”

Section: Discussionmentioning

confidence: 86%

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

Yang

Wei

2023

Eur J Med Res

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Background Gouty 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. Methods This 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. Results Rapidly 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). Conclusion No 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.

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“…Early and aggressive control hyperuricemia by probenecid with colchicine could not induce higher pain severity and duration in our study. In the other study, the chronic GA patients with a serum CRP level > 3 mg/dL who did not take prophylaxis were associated with gout are recurrence during initial ULT therapy [27].…”

Section: Discussionmentioning

confidence: 87%

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

Yang

Wei

2022

Preprint

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Background Gouty 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. Methods This 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 two weeks after the initial therapy. Results Rapidly decreasing 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 (-1.77 ± 2.037 vs 1.24 ± 2.084; P < 0.0001). However, the mean decrease in visual analog scale score did not differ significantly between the two groups (-5.20 ± 3.09 vs -3.63 ± 2.38; P = 0.079). Conclusion No 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.

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Prognostic factors associated with early gout flare recurrence in patients initiating urate-lowering therapy during an acute gout flare

Cited by 10 publications

References 34 publications

Combined Use of Febuxostat and Colchicine Does Not Increase Acute Hepatotoxicity in Patients with Gout: A Retrospective Study

Combined Use of Febuxostat and Colchicine Does Not Increase Acute Hepatotoxicity in Patients with Gout: A Retrospective Study

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

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

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