Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Feng, Xiaogang; Li, Yao; Gao, Wei

doi:10.1016/j.jbspin.2015.02.021

Cited by 23 publications

(21 citation statements)

References 16 publications

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“…A hospital-based retrospective study which examined the effect of initiation of ULT during an acute gout attack reported that patients commenced on ULT during an acute attack were significantly more likely to meet the SUA target earlier and less likely to have chronic kidney disease in the long term [9]. However, the findings of this study may be biased due to its retrospective observational nature.…”

Section: Discussionmentioning

confidence: 99%

Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review

et al. 2016

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The aim of this study was to systematically review the literature on effect of initiating urate-lowering treatment (ULT) during an acute attack of gout on duration of index attack and persistence on ULT. OVID (Medline), EMBASE and AMED were searched to identify randomized controlled trials (RCTs) of ULT initiation during acute gout attack published in English language. Two reviewers appraised the study quality and extracted data independently. Standardized mean difference (SMD) and relative risk (RR) were used to pool continuous and categorical data. Meta-analysis was carried out using STATA version 14. A total of 537 studies were selected. A total of 487 titles and abstracts were reviewed after removing duplicates. Three RCTs were identified. There was evidence from two high-quality studies that early initiation of allopurinol did not increase pain severity at days 10–15 [SMDpooled (95 % CI) 0.18 (−0.58, 0.93)]. Data from three studies suggested that initiation of ULT during an acute attack of gout did not associate with dropouts [RRpooled (95 % CI) 1.16 (0.58, 2.31)]. There is moderate-quality evidence that the initiation of ULT during an acute attack of gout does not increase pain severity and risk of ULT discontinuation. Larger studies are required to confirm these findings so that patients with acute gout can be initiated on ULT with confidence.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3579-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review

et al. 2016

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“…There is no consensus regarding the timing of ULT initiation. [13][14][15] On one end of the spectrum, some physicians believe that the first gout flare is preceded by years of silent MSU crystal deposition and hence would be inclined to start ULT after the first flare. They suggest that delayed treatment might allow further MSU crystal deposition and thus promote inflammation and joint destruction.…”

Section: Timing Of Ult Initiation Is Controversialmentioning

confidence: 99%

“…Yet another study, a retrospective study found that initiation of ULT during acute flares led to more frequent flares in the first 12-weeks following the initial flare. 14 Thus, initiating ULT during acute flares needs further study.…”

Section: Can We Start Ult During An Acute Flare?mentioning

confidence: 99%

Contentious Issues in Gout Management: The Story so Far

Talaat

Park

Schlesinger

2021

OARRR

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Gout is the most common inflammatory arthritis worldwide. Although gout has been known for antiquity, many challenges still exist in gout management. It is vital to view gout as a chronic disease and not just treat the acute flare. There is a perception of gout as an acute disease requiring treatment only for acute flares. However, to combat the disease, chronic uratelowering therapy, reducing the serum urate levels to below the saturation threshold of 6.8 mg/dL, and chronic anti-inflammatory prophylaxis, especially during urate-lowering therapy initiation, are needed. In this manuscript, we discuss some of the contentious issues in gout management. These include the timing of urate-lowering therapy initiation, which urate-lowering therapy to chose, should comorbidities influence our treatment, using genetic determinants, and patient perspectives to drive treatment and differences between gout treatment the American College of Physicians and Rheumatology guidelines for gout management: driving care.

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“…X. Feng и соавт. [35] ретроспективно проанализировали данные о влиянии УСТ на текущий артрит и пришли к выводу, что назначение терапии не приводит к ухудшению его проявлений. Однако этот аспект нельзя обсуждать отдельно от симптоматической терапии.…”

Section: время начала уст «когда принимается решение о назначении устunclassified

“…Если она эффективна, то можно параллельно назначить УСТ, особенно если в дальнейшем будет проводиться профилактика приступов, о которой шла речь выше. Те же авторы показали, что частота приступов после начата приема уратснижающих средств, возрастала, и это подтверждает необходимость перехода от «симптоматической» терапии к «профилактической» после стихания обострения [35]. Кроме того, при тяжелом артрите ожидание полного его купирования может существенно отодвинуть сроки начала УСТ.…”

Section: время начала уст «когда принимается решение о назначении устunclassified

Commentaries on the updated American College of Rheumatology guidelines for the management of gout. Urate-lowering drugs (Part 1)

Елисеев¹

2020

Sovremennaâ revmatologiâ

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The emergence of updated American College of Rheumatology (ACR) guidelines for the management of gout may serve as a prerequisite for revising the draft Russian Federal Clinical Guidelines (FCGs). Despite some differences, it should be noted that both guidelines are similar in key points concerning the principles of drug correction of hyperuricemia, indications for prescription and algorithms for the use of specific medicaments. The proximity of positions can be also traced in the need for the priority use of xanthine oxidase inhibitors (allopurinol and febuxostat) for urate-lowering therapy (ULT), which is aimed at implementing the target principle of gout management – the strict, constant control of serum levels of uric acid (its value should not exceed 6 mg/dl, or 360 μmol/l). The practical results of ULT in accordance with the basic principles outlined in the FCG have been published earlier.

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Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Cited by 23 publications

References 16 publications

Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review

Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review

Contentious Issues in Gout Management: The Story so Far

Commentaries on the updated American College of Rheumatology guidelines for the management of gout. Urate-lowering drugs (Part 1)

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