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Fan Y, Zhu C, Ji Y, Peng J, Wang G, Wan R, Liu W. Comparison of efficacy of acupuncture-related therapies in treating Acute Gouty Arthritis: A Network Meta-Analysis of Randomized Controlled Trials. Heliyon 2024; 10:e28122. [PMID: 38576580 PMCID: PMC10990962 DOI: 10.1016/j.heliyon.2024.e28122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/06/2024] Open
Abstract
Background and purpose: Acupuncture and moxibustion, as a complementary and alternative therapy, has been widely used in the treatment of acute gouty arthritis (AGA). However, there are various forms of acupuncture and moxibustion, and the curative effect of different forms is different. This study evaluated the clinical efficacy of different acupuncture therapies in treating AGA by network meta-analysis. Methods Computer searches of English databases (including PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Embase) and Chinese databases (including China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Database and China Biomedical Literature Database) were conducted for randomized controlled trials (RCTs) of acupuncture therapies in treating AGA. We set the search time from the database establishment to May 2022. Data analysis was performed using Stata14.2 software. Results Thirty-two RCTs involving 2434 patients with AGA were screened out. The results showed that in terms of the improvement of pain visual analogue scale (VAS) scores, the top ones were acupoint application (100%), electroacupuncture + Western medicine (73.5%) and acupuncture + Western medicine (69.2%); In terms of total effective rate, acupoint application (85.2%), acupuncture (75.2%) and acupuncture + Western medicine (63%) ranked the top; In terms of reducing serum uric acid (SUA) levels, the top ones were acupoint application (95%), acupuncture + Western medicine (87.5%) and acupuncture (66.2%); In terms of the reduction of erythrocyte sedimentation rate (ESR), acupuncture (95%), acupoint application (84.7%), and electroacupuncture + Western medicine (52.8%) were the most prominent. Conclusion The existing evidence shows that acupoint application has more advantages in improving the total effective rate, improving pain and reduce SUA levels, and acupuncture has an advantage in reducing ESR levels and adverse events. However, due to the low qualities of the original studies, the quality of this evidence is poor. Therefore, it is recommended that more scientific research be performed to confirm the efficacy of acupuncture.
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Affiliation(s)
- Yihua Fan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Chengcheng Zhu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China
| | - Yue Ji
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Jing Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China
| | - Guanran Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Renhong Wan
- Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan Province, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
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Jatuworapruk K. Toward a holistic tophus assessment in gout clinical trials: What lies beyond tophus count and size? Int J Rheum Dis 2024; 27:e15109. [PMID: 38450846 DOI: 10.1111/1756-185x.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/10/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Kanon Jatuworapruk
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
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Pascart T, Ducoulombier V, Jauffret C. Early-onset gout. Joint Bone Spine 2024; 91:105704. [PMID: 38336273 DOI: 10.1016/j.jbspin.2024.105704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Early-onset gout (EOG) is characterized by the occurrence of the first symptoms of gout at an unusually young age, usually <40 years. The aim of this review is to provide an overview of the epidemiology, clinical presentation and prognosis, association with comorbidities and specific management of EOG. A particularly high proportion of patients with EOG come from ethnic groups with stronger genetic factors, such as populations in the Pacific and Taiwan, who therefore have the highest prevalence of gout overall. The clinical presentation and severity of gout are broadly similar between EOG and common gout, although a longer disease duration exacerbates the disease, which more often tends to become polyarticular. Patients suffering from EOG develop metabolic comorbidities commonly associated with gout earlier in life, although those tend to be less frequent at the time of diagnosis. Some international guidelines recommend early treatment of EOG patients with urate-lowering therapies.
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Affiliation(s)
- Tristan Pascart
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France; ETHICS Laboratory, EA7446, Lille Catholic University, Lille, France.
| | - Vincent Ducoulombier
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France
| | - Charlotte Jauffret
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France; University of Lille, ULR 2694 - METRICS, CERIM, Lille, France
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4
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Hsu TM, Chang HW, Chen AL, Wei JCC. Comment on serum urate-lowering efficacy and safety of Tigulixostat in gout patients with hyperuricemia: A randomized, double-blind, placebo-controlled, dose-finding trial. Int J Rheum Dis 2024; 27:e15024. [PMID: 38287554 DOI: 10.1111/1756-185x.15024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/23/2023] [Indexed: 01/31/2024]
Affiliation(s)
- Tai-Ming Hsu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hui Wen Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ai-Lin Chen
- School of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Allergy, Immunology, and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Laosuksri P, Phrintrakul N, Gumtorntip W, Na-Nan K, Wongthanee A, Kasitanon N, Louthrenoo W. Non-loading versus loading low-dose colchicine in acute crystal-associated arthritis: A double-blinded randomized controlled study. Int J Rheum Dis 2023; 26:2478-2488. [PMID: 37860923 DOI: 10.1111/1756-185x.14943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/01/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION This study aimed to compare the efficacy of non-loading versus loading low-dose colchicine in patients with acute crystal-associated arthritis. MATERIALS AND METHODS All in-patients who were admitted to Chiang Mai University Hospital with non-arthritis disease and developed acute crystal-associated arthritis during admission (within 48 h after arthritis onset) were invited to join this study. The patients were randomized into two groups. Patients in Group I (non-loading group) and Group II (loading group) received colchicine at 1.2 and 2.4 mg in the first 24 h, respectively. The primary outcome was the patients' pain response at 24 h after treatment. RESULTS Of 80 patients, 49 were acute gouty arthritis, and 31 acute calcium pyrophosphate (CPP) arthritis. The mean [95% CI] pain score was no different between Groups I and II at the baseline level (6.46[5.72-7.19] vs. 6.654[5.85-7.44], p = .867) and at 24 h (3.13[2.43-3.82] vs. 3.18[2.42-3.93], p = .907). The proportion of patients with ≥50% pain reduction was not different (57.50% vs. 55.00%, p = .822). Sensitivity analysis among patients with a baseline pain score of ≥4 showed the same pattern of response. Mild diarrhea was common and comparable in both groups. Subgroup analysis according to renal function (eGFR < 60 vs. ≥60 mL/min/1.73 m2 ) or type of crystals (acute gouty arthritis vs. acute CPP arthritis) also showed the same pattern of response. CONCLUSION Non-loading low-dose colchicine was as effective as loading low-dose colchicine in patients with acute crystal-associated arthritis, regardless of renal function or type of crystals.
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Affiliation(s)
- Ployrung Laosuksri
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Sawanpracharak Hospital, Nakorn Sawan, Thailand
| | - Nathrudee Phrintrakul
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Lanna Hospital, Chiang Mai, Thailand
| | - Wanitcha Gumtorntip
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittiya Na-Nan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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So MW, Kim AR, Lee SG. Analysis of appropriate duration of colchicine prophylaxis to maximize the persistence of xanthine oxidase inhibitors as the first-line urate-lowering therapy in patients with gout using the Korean Health Insurance Review and Assessment Service database. Int J Rheum Dis 2023; 26:1770-1778. [PMID: 37431263 DOI: 10.1111/1756-185x.14825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/13/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION We investigated the appropriate duration of colchicine prophylaxis to maximize the persistence of xanthine oxidase inhibitors (XOIs) as first-line urate-lowering therapy (ULT) in patients with gout. This was a nationwide population-based retrospective cohort study using the Korean Health Insurance Review and Assessment database. METHODS Patients with gout aged ≥20 years who were newly initiated on XOIs, such as allopurinol or febuxostat, from July 2015 to June 2017 and received these medications for ≥6 months were analyzed and followed up until June 2019. Persistence of XOIs was compared according to the 6-month duration of colchicine prophylaxis. For additional subgroup analysis, we also compared the persistence of XOIs according to the 3-month duration of colchicine prophylaxis. RESULTS This study included 43 926 patients. The frequencies of patients with gout receiving colchicine prophylaxis for ≥6 months and ≥3 months were 6.3% and 7.6%, respectively. Allopurinol (65.2%) was prescribed more frequently than febuxostat (34.8%). During the study period, 23 475 patients (53.4%) stopped using XOIs. Colchicine prophylaxis for ≥6 months did not significantly reduce the risk of XOI discontinuation in multivariable Cox regression models. Colchicine prophylaxis for ≥3 months was significantly associated with a lower risk of non-persistence to XOIs after adjusting for confounding factors (hazard ratio = 0.95, p = .041). CONCLUSION Our data suggest that at least 3 months of colchicine prophylaxis may be more appropriate than at least 6 months in terms of maximizing the persistence of XOIs in patients with gout.
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Affiliation(s)
- Min Wook So
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - A-Ran Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Seung-Geun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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7
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Jatuworapruk K, De Vera R, Estrella AM, Sollano MHMZ, Vaidya B, Rahman MM, Lim AL, Wulansari Manuaba IAR, Hellmi RY, Keen H, Lorenzo JP. The APLAR Gout Registry: A multinational collaboration to better understand people with gout in the Asia-Pacific. Int J Rheum Dis 2023; 26:1432-1434. [PMID: 37527022 DOI: 10.1111/1756-185x.14765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 08/03/2023]
Affiliation(s)
| | | | | | | | - Binit Vaidya
- National Center for Rheumatic Diseases, Kathmandu, Nepal
| | | | - Ai Lee Lim
- Penang General Hospital, Penang, Malaysia
| | | | - Rakhma Yanti Hellmi
- Dr Kariadi General Hospital Medical Center, Diponegoro University, Semarang, Indonesia
| | - Helen Keen
- University of Western Australia, Perth, Western Australia, Australia
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8
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Conley B, Bunzli S, Bullen J, O’Brien P, Persaud J, Gunatillake T, Dowsey MM, Choong PF, Nikpour M, Grainger R, Lin I. What are the core recommendations for gout management in first line and specialist care? Systematic review of clinical practice guidelines. BMC Rheumatol 2023; 7:15. [PMID: 37316871 PMCID: PMC10268528 DOI: 10.1186/s41927-023-00335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Gout is the most common inflammatory arthritis, increasing in prevalence and burden. Of the rheumatic diseases, gout is the best-understood and potentially most manageable condition. However, it frequently remains untreated or poorly managed. The purpose of this systematic review is to identify Clinical Practice Guidelines (CPG) regarding gout management, evaluate their quality, and to provide a synthesis of consistent recommendations in the high-quality CPGs. METHODS Gout management CPGs were eligible for inclusion if they were (1) written in English and published between January 2015-February 2022; focused on adults aged ≥ 18 years of age; and met the criteria of a CPG as defined by the Institute of Medicine; and (2) were rated as high quality on the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Gout CPGs were excluded if they required additional payment to access; only addressed recommendations for the system/organisation of care and did not include interventional management recommendations; and/or included other arthritic conditions. OvidSP MEDLINE, Cochrane, CINAHL, Embase and Physiotherapy Evidence Database (PEDro) and four online guideline repositories were searched. RESULTS Six CPGs were appraised as high quality and included in the synthesis. Clinical practice guidelines consistently recommended education, commencement of non-steroidal anti-inflammatories, colchicine or corticosteroids (unless contraindicated), and assessment of cardiovascular risk factors, renal function, and co-morbid conditions for acute gout management. Consistent recommendations for chronic gout management were urate lowering therapy (ULT) and continued prophylaxis recommended based on individual patient characteristics. Clinical practice guideline recommendations were inconsistent on when to initiate ULT and length of ULT, vitamin C intake, and use of pegloticase, fenofibrate and losartan. CONCLUSION Management of acute gout was consistent across CPGs. Management of chronic gout was mostly consistent although there were inconsistent recommendations regarding ULT and other pharmacological therapies. This synthesis provides clear guidance that can assist health professionals to provide standardised, evidence-based gout care. TRIAL REGISTRATION The protocol for this review was registered with Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/UB3Y7 ).
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Affiliation(s)
- Brooke Conley
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065 Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC Australia
| | - Samantha Bunzli
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD Australia
- Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, QLD Australia
| | | | - Penny O’Brien
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065 Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, WA Australia
| | - Tilini Gunatillake
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065 Australia
| | - Michelle M Dowsey
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065 Australia
| | - Peter F Choong
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065 Australia
| | - Mandana Nikpour
- Departments of Medicine and Rheumatology, The University of Melbourne at St. Vincent’s Hospital, Melbourne, VIC Australia
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
- Te Whatu Ora Health New Zealand – Capital Coast and Hutt Valley, Wellington, New Zealand
| | - Ivan Lin
- The University of Western Australia, Western Australian Centre for Rural Health, Geraldton, WA Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA Australia
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9
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Comment on: “Risk of Erectile Dysfunction in Male Patients with Gout Treated with Febuxostat or Allopurinol: A Propensity Score-Matched Cohort Study”. Drugs 2023. [PMCID: PMC10020758 DOI: 10.1007/s40265-023-01849-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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10
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Authors’ Reply to Huang and Zhang: Comment on “Risk of Erectile Dysfunction in Male Patients with Gout Treated with Febuxostat or Allopurinol: A Propensity Score-Matched Cohort Study”. Drugs 2023. [PMCID: PMC10020747 DOI: 10.1007/s40265-023-01850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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11
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Grubišić F, Jordan K. Are interventions for treatment of tophi in gout efficient? - A Cochrane Review summary with commentary. Int J Rheum Dis 2023. [PMID: 36891663 DOI: 10.1111/1756-185x.14648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/03/2023] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Frane Grubišić
- Department of Rheumatology, Physical Medicine and Rehabilitation, School of Medicine University of Zagreb, Referral Center for Spondyloarthropathies, Ministry of Health of the Republic of Croatia, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
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12
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Dang W, Zhao L, Wang J, Xu D, Liu J, You L. Association between serum uric acid levels of patients with gout and their complications and examination fees: A cross-sectional analysis. Int J Rheum Dis 2023; 26:673-681. [PMID: 36789953 DOI: 10.1111/1756-185x.14609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Correlation influence factor analysis of gout patients' serum uric acid (SUA) levels, their examination fees, and various complications were explored. METHODS From January 2017 to December 2021, 17 666 patients with gout were obtained. Conduct quartile grouping according to gout patients' SUA levels was used to compare the differences between groups in terms of examination fees and complications. Kernel density estimation method was adopted to analyze the data distribution, Spearman and Mantel-Haenszel χ2 tests were used to analyze the correlation between SUA levels and examination fees and complications. Binary logistic regression analysis was used to analyze the correlation influence factor between SUA levels and complications. RESULTS Of the 17 666 gout cases, 85.46% were male. Among them, 7637 (43.23%) were inpatients and 10 029 (56.77%) were outpatients. Compared with outpatients, age, SUA levels, and examination fees were significantly higher, and there were more complications among inpatients (P < 0.05). Correlation analysis revealed that outpatients and SUA levels of patients with gout were positively correlated with examination fees, cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases (P < 0.01). Binary logistic regression analysis showed that SUA level is an independent influence factor for cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases (odds ratio [95% confidence interval]: 1.002 [1.002-1.002], 1.001 [1.000-1.001], 1.003 [1.002-1.003], and 1.001 [1.001-1.002], respectively). CONCLUSIONS As SUA levels increased, examination fees, cardiovascular disease, pulmonary disease, liver disease, and kidney disease complications increased. SUA level is an independent influence factor for the combination of gout with cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases.
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Affiliation(s)
- Wantai Dang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Ling Zhao
- Department of Ultrasound, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jing Wang
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Dan Xu
- Department of nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jian Liu
- Department of Ultrasound, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Lanlan You
- Department of Ultrasound, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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13
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Xu Q, Lin CS. An interesting tophus in gingiva. Int J Rheum Dis 2023; 26:401-402. [PMID: 36468714 DOI: 10.1111/1756-185x.14522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Qiang Xu
- Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Rheumatology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chang-Song Lin
- Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Rheumatology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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14
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Tsai YS, Lee YH, Ko MY. Letter to the editor regarding "urate-lowering therapy for patients with gout on hemodialysis". Int J Rheum Dis 2023; 26:177-178. [PMID: 36250780 DOI: 10.1111/1756-185x.14469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Yung-Shun Tsai
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yung-Heng Lee
- Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.,Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu, Taiwan.,Department of Recreation and Sport Management, Shu-Te University, Kaohsiung, Taiwan
| | - Meng-Yu Ko
- Division of Gastroenterology and Hepatology, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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15
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Yin N, Li X, Liu W, Qi Y, Wu R, Li Z, Ying S, Yang H, Gu Q, Wu Z, Zou N, Duan W, Peng J, Wan C. Jian Pi Shen Shi formula alleviates hyperuricemia and related renal fibrosis in uricase-deficient rats via suppression of the collagen-binding pathway. Int J Rheum Dis 2022; 25:1395-1407. [PMID: 36082436 DOI: 10.1111/1756-185x.14434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/17/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022]
Abstract
AIM Jian Pi Shen Shi Formula (JPSSF) is a beneficial treatment for hyperuricemia and related tissue damage in the clinical setting. This study was designed to investigate its therapeutic potential and underlying mechanisms in uricase-deficient rats (Uox-/- rats). METHODS Uox-/- rats were used to assess the therapeutic potential of JPSSF on hyperuricemia. Protein extracts from renal tissues of a Uox-/- group and a JPSSF group were analyzed using tandem mass tag labeling quantitative proteomic workflow. Collagen deposition in Uox-/- rat kidneys was analyzed by Masson trichromatic staining. The gene expression associated with collagen-binding-related signaling pathways in the kidneys was further explored using quantitative polymerase chain reaction assay. The protein expressions of collagen 1a1 (col1a1), col6a1, and α-smooth muscle actin were measured by Western blotting and immunohistochemistry. RESULTS JPSSF significantly decreased renal function indices and alleviated renal injuries. The action of JPSSF was manifested by down-regulation of col6a1 and interleukin-1 receptor-associated kinase-like 2, which blocked the binding sites on collagen and further prevented kidney injury. The anti-renal fibrosis effect of JPSSF was confirmed by reducing the collagen deposition and hydroxyproline concentrations. JPSSF treatment also intensely down-regulated the mRNA and protein expressions of col6a1, col1a1, and α-smooth muscle actin, which inhibited the function of the collagen-binding-related signaling pathway. CONCLUSION Our results indicated that JPSSF notably ameliorated hyperuricemia and related renal fibrosis in Uox-/- rats through lowering uric acid and down-regulating the function of the collagen-binding pathway. This suggested that JPSSF is a potential empirical formula for treating hyperuricemia and accompanying renal fibrosis.
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Affiliation(s)
- Na Yin
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Xiaosi Li
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Weichao Liu
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yan Qi
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Runfang Wu
- School of Basic Medicine, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Zhaofu Li
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China.,School of Basic Medicine, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Sai Ying
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China.,School of Basic Medicine, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Haihao Yang
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Qianlan Gu
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Zhao Wu
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Nanting Zou
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Weigang Duan
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China.,School of Basic Medicine, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Jiangyun Peng
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Chunping Wan
- School of Clinical Medicine and School of Pharmacy, Yunnan University of Traditional Chinese Medicine, Kunming, China
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16
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Efficacy and Safety of Qinpi Tongfeng Formula in the Treatment of Acute Gouty Arthritis: A Double-Blind, Double-Dummy, Multicenter, Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7873426. [PMID: 35865342 PMCID: PMC9296295 DOI: 10.1155/2022/7873426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/25/2022] [Indexed: 11/18/2022]
Abstract
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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17
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Park EH, Choi ST, Song JS. Current state and prospects of gout treatment in Korea. Korean J Intern Med 2022; 37:719-731. [PMID: 35811361 PMCID: PMC9271716 DOI: 10.3904/kjim.2022.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/23/2022] [Indexed: 11/27/2022] Open
Abstract
Effective management of gout includes the following: appropriate control of gout flares; lifestyle modifications; management of comorbidities; and long-term urate-lowering therapy (ULT) to prevent subsequent gout flares, structural joint damage, and shortening of life expectancy. In addition to traditional treatments for gout, novel therapies have been introduced in recent years. Indeed, new recommendations for the management of gout have been proposed by various international societies. Although effective and safe medications to treat gout have been available, management of the disease has continued to be suboptimal, with poor patient adherence to ULT and failure to reach serum urate target. This review outlines recent progress in gout management, mainly based on the latest published guidelines, and specifically provides an update on efficient strategies for implementing treatment, efficacy and safety of specific medications for gout, and cardiovascular outcomes of ULT. In particular, we reviewed gout management approaches that can be applied to a Korean population.
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Affiliation(s)
- Eun Hye Park
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Sang Tae Choi
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jung Soo Song
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
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18
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Yan J, Zhou Y, Yang Q, Wu J, He X. Evaluation of the safety and efficacy of a Fuling-Zexie decoction for people with asymptomatic hyperuricemia: protocol for a prospective, double-blinded, randomized, placebo-controlled clinical trial. Trials 2022; 23:517. [PMID: 35725639 PMCID: PMC9208148 DOI: 10.1186/s13063-022-06479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Hyperuricemia increases the risk of gout and cardiovascular complications, and how to manage asymptomatic hyperuricemia is controversial. Randomized controlled trials and comparative studies are needed to guide management and treatment. Studies show that Chinese medicine can decrease uric acid through multiple targets, but many of these studies have been conducted in animals because of the lack of a consistent prescription and mechanism. Therefore, we designed this research to study whether Chinese medicine is truly effective and which target is essential by using an approved prescription of a Fuling-Zexie decoction to further guide large sample experiments to determine whether Chinese medicine can reduce the long-term incidence of gout and cardiovascular events. Methods This pilot study is a prospective, double-blinded, randomized, placebo-controlled clinical trial developed from March 2020 to December 2021. Thirty people with asymptomatic hyperuricemia will be recruited and assigned to either the Chinese medicine group or placebo group, and each group will have 15 subjects. During the 12-week observation period, there will be 4 visits. The decline in uric acid is the main outcome measure, and urinary uric acid, inflammatory biomarkers, and other indices that may be involved in lowering uric acid are the secondary outcome measures. Discussion This study will probe the effect of Chinese medicine treatment on hyperuricemia and explore possible therapeutic mechanisms. By performing this trial, we hope to provide evidence and data to support further large clinical studies. Trial registration ChiCTR2000038575. Registered on September 24, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06479-3.
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Affiliation(s)
- Jingyao Yan
- Department of Rheumatology, Guangdong Provincial Hospital of Chinese Medicine, No. 55 of Neihuanxi Road, Higher Education Mega Center, Guangzhou, 510006, China
| | - Yingyan Zhou
- Department of Rheumatology, Guangdong Provincial Hospital of Chinese Medicine, No. 55 of Neihuanxi Road, Higher Education Mega Center, Guangzhou, 510006, China
| | - Qiaowen Yang
- Department of Rheumatology, Guangdong Provincial Hospital of Chinese Medicine, No. 55 of Neihuanxi Road, Higher Education Mega Center, Guangzhou, 510006, China
| | - Jiaqi Wu
- Department of Rheumatology, Guangdong Provincial Hospital of Chinese Medicine, No. 55 of Neihuanxi Road, Higher Education Mega Center, Guangzhou, 510006, China
| | - Xiaohong He
- Department of Rheumatology, Guangdong Provincial Hospital of Chinese Medicine, No. 55 of Neihuanxi Road, Higher Education Mega Center, Guangzhou, 510006, China. .,State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111 Dade Road, Yuexiu District, Guangzhou, 510120, China.
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19
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Wei JC. IJRD in the Year of Tiger: We aim for an impact factor of 5 in the next 3 years. Int J Rheum Dis 2022; 25:513-516. [DOI: 10.1111/1756-185x.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- James Cheng‐Chung Wei
- Department of Allergy, Immunology & Rheumatology Chung Shan Medical University Hospital Taichung Taiwan
- Institute of Medicine Chung Shan Medical University Taichung Taiwan
- Graduate Institute of Integrated Medicine China Medical University Taichung Taiwan
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Jatuworapruk K, Dalbeth N. Are we asking the right questions about urate-lowering therapy? Comment on the 2021 Asia-Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout. Int J Rheum Dis 2022; 25:714-715. [PMID: 35485609 DOI: 10.1111/1756-185x.14327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kanon Jatuworapruk
- Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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