Introduction: When initiating urate-lowering therapy, using anti-inflammatory prophylaxis therapy for at least 3 to 6 months is strongly recommended. Previous studies have found that zhengqing fengtongning sustained-release tablets (sinomenine) can improve inflammation in the acute phase of gout; however, the efficacy of urate-lowering therapy in reducing frequency of acute flares still needs to be investigated. The aim of the present study is to explore the efficacy and safety of sinomenine for prophylaxis of acute flares when initiating urate-lowering therapy.
Methods And Analysis: This randomized, placebo-controlled, double-blinded trial will include a total of 210 gout patients who meet the study criteria. The patients will be randomized (1:1) to the test group and the control group. The intervention is planned to be performed for 12 weeks with a follow-up of 12 weeks. All patients would be administered febuxostat (40 mg/d) and concomitant anti-inflammatory prophylaxis therapy. Sinomenine and colchicine placebo are administered in the sinomenine group, sinomenine placebo and colchicine are administered in the colchicine group. The primary outcome is the rate of acute gout flares in subjects within 12 weeks of the treatment period. The secondary outcomes include the times of acute gout flares and the duration of each acute flares within 12 weeks; the compliance rate in patients whose UA levels ≤6.0 mg/dL (360 μmol/L) at the weekend of 2nd, 4th, 8th, and 12th week in each group; the proportion of patients with ≥1 and ≥2 gout flares within 12 weeks; average visual analogue scale/score pain score during gout flares; and the oral dose of etoricoxib will be used to control the onset of acute flares within 12 weeks.
Ethics And Dissemination: The Institutional Medical Ethics Committee have approved the trial protocol. We plan to publish the results of this study in a peer-reviewed journal.
Trial Registration: ChiCTR, ChiCTR2100045114, Registered 8 April 2021 http://www.chictr.org.cn/showproj.aspx?proj=124688.
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http://dx.doi.org/10.1097/MD.0000000000029199 | DOI Listing |
J Orthop Case Rep
January 2025
Arthritis and Breast Care Centre, Kurukshetra, Haryana, India.
Introduction: Gouty arthritis is a common inflammatory condition caused by the deposition of uric acid crystals in the joints, leading to intense pain, swelling, and functional impairment. Thermal therapies, including hot and cold fomentation, are often used as adjunctive treatments for managing inflammation and pain in various musculoskeletal conditions. However, the efficacy of these therapies in acute gout remains underexplored.
View Article and Find Full Text PDFArthritis Care Res (Hoboken)
January 2025
Rutgers Ernest Mario School of Pharmacy, Piscataway, NJ.
Arthritis Care Res (Hoboken)
January 2025
Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Endocrinol Diabetes Nutr (Engl Ed)
January 2025
Francesc de Borja Hospital, Gandía, Spain.
Introduction: Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) were shown to lower hyperuricemic events in patients with type 2 diabetes mellitus (T2DM), the extent of this effect in the general population is yet to be elucidated. We performed an updated systematic review and meta-analysis on a large sample of patients with and without T2DM to evaluate the influence of SGLT2i therapy on clinically relevant hyperuricemic events, defined as the composite of acute gout flare episodes, acute anti-gout management or urate-lowering therapy initiation. Furthermore, we conducted a multivariate meta-regression to assess the relationship between different covariates and the pooled effect size.
View Article and Find Full Text PDFRheumatology (Oxford)
January 2025
Amgen Inc, Thousand Oaks, CA, USA.
Objectives: Long-term maintenance of serum urate (SU) levels <6 mg/dl reduces gout flare frequency. However, urate-lowering therapy (ULT) initiation can induce gout flare. The incidence of thromboembolic (TE) and cardiovascular (CV) events has been shown to increase in the 30 and 120 days following gout flare, respectively; therefore, the question of ULT initiation increasing patient risk for CV/TE events has been raised.
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