Evaluation of febuxostat initiation during an acute gout attack: A prospective, randomized clinical trial - 26/09/20
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Highlights |
• | Initiation of urate-lowering treatment during an acute gout flare is still inconclusive as lacks of clinical evidences. |
• | We demonstrate an early achievement of target serum urate of febuxostat initiation during an acute gout flare. |
• | No significant difference in daily pain, recurrent flares, inflammation indicators or adverse effects are shown with initiation of febuxostat. |
• | The well compliance of febuxostat initiation during an attack suggests potential long-term benefits in acute gout patients. |
Abstract |
Objective |
Urate-lowering treatment (ULT) is recommended in gout management. However, initiation of ULT during an acute gout flare is still inconclusive. This study aimed to evaluate the efficacy and safety of the ULT febuxostat administered at initiation of an acute gout attack.
Methods |
A prospective randomized controlled clinical trial was conducted for 12 weeks in primary gout patients who were admitted with acute gout attacks. Subjects were randomly assigned to the febuxostat group in which febuxostat, 40mg daily, was administered in the primary care setting for attacks, or to the control group in which febuxostat, 40mg daily, was administered after the attacks. All patients received adequate anti-inflammatory and analgesic therapies. Serum urate (SU) levels were monitored throughout the study. Pain, measured using a visual analogue scale (VAS), and gout recurrence rate were used as primary outcomes. Flare-related inflammation biomarkers were selected as secondary outcomes.
Results |
Fifty-two patients completed the study (febuxostat group: n=28; control group: n=24). No significant differences were detected in VAS scores between the two groups over the first 14-day observation period (P>0.05). Administration of febuxostat decreased SU levels significantly during the first 2-week period. However, the gout recurrent rate or gout flare-related inflammation indicators did not change in the febuxostat or control groups. Treatment-related adverse events were mild and similar between groups.
Conclusion |
Initiation of the urate-lowering drug febuxostat during an acute gout attack caused no significant difference in daily pain, recurrent flares, or adverse effects. The treatment significantly decreased SU levels in the early stage and might have potential long-term benefits in these patients.
Le texte complet de cet article est disponible en PDF.Keywords : Acute gout flare, Febuxostat, Urate-lowering therapy, Evaluation
Plan
Vol 87 - N° 5
P. 461-466 - octobre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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