Study of efficacy and duration of urate-lowering therapy in patients with gout
Summary. The objective: to study the efficacyof urate-lowering therapy, such as febuxostat, in patients with gout. Materials and methods. The study involved 85 patients (73 men,12 women) aged 47–57 years with a confirmed diagnosis of gout. Questionnaire methods, laboratory (uric acid, CRP, ESR), instrumental (X-ray ultrasound examination of joints) methods were used, VAS, number of attacks, gout activity index and biomedical statistics methods were calculated. Febuxostat was used for the treatment of gout at a dose of 60–80 mg once a day. The duration of observation was 6 months. Results. A statistically significant decrease in uric acid levels was found from 523.0 (interquartile range — 470.0–600.0) to 326.0 (283.5–359.5) μmol/l, VAS from 7.00 (2.00–6.00) to 2.00 (2.00–3.00), the number of attacks per month and per 12 months, respectively. A decrease in the gout activity index was determined from 8.3 (7.8–9.3) to 5.3 (4.8–5.8), although a remission index of <2.5 was not achieved. After treatment with Eurofeb (febuxostat, Euro Lifecare, UK)the size and number of erosions and tophus did not change. A statistically significant decrease in CRP from 8.00 (5.60–17.32) to 4.18 (2.395–5.60) mg/l and ESR from 15.50 (10.00–22.00) to 10.00 (7.00–15.00) mm/h was found. Conclusions. The duration of Eurofeb administration should be from 6 months to obtain statistically significant clinical and laboratory remission, dissolution of tophus. For patients undergoing urate-lowering therapy, the level of sUA <5 mg/dl; 300 μmol/l is recommended for patients with severe gout and tophus. Given the positive effect on pro-inflammatory ESR and CRP levels, there is a possibility of prescribing Eurofeb during an acute attack of gout.
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