Abstract
Objective:To evaluate the efficacy of atorvastatin combined with febuxostat in the treatment of gout patients with carotid atherosclerosis and to observe the effects on serum tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and C-reactive protein (CRP) levels, carotid plaques, and the adverse reactions.Methods:Seventy patients with gout and carotid atherosclerosis admitted to Affiliated Hospital of Hebei University from January 2014 to June 2017 were randomly divided into a treatment group and a control group. The treatment group received oral febuxostat 40 mg/day combined with atorvastatin 40 mg/day. The control group was given 40 mg/day febuxostat combined with 20 mg/day atorvastatin for 90 days. The effects of treatment on TNF-α, IL-1β, and CRP levels and carotid plaques of the patients were observed.Results:After 90 days of treatment, serum TNF-α, IL-1β, and CRP levels, as well as HUA and total cholesterol (TC), decreased in both groups after treatment. There were significant differences observed (p < 0.05). The carotid artery plaques in the two groups were significantly smaller after treatment (P<0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05).Conclusion:Double doses of atorvastatin combined with febuxostat can effectively reduce uric acid to improve the inflammatory state in patients and reduce carotid plaques without increasing the incidence of adverse reactions.
Highlights
Gout is a group of diseases caused by a purine metabolism disorder that is closely related to hyperuricemia (HUA)
Adverse reactions: There was no significant difference in adverse reactions between the two groups (P > 0.05)
The results showed that tumor necrosis factor-α (TNF-α), IL-1β, C-reactive protein (CRP) and other inflammatory indexes in the treatment group were significantly lower than those in the control group
Summary
Gout is a group of diseases caused by a purine metabolism disorder that is closely related to hyperuricemia (HUA). Studies have shown that the prevalence of HUA in China is 12.08 %,1 which is significantly higher than it was 30 years ago, and that HUA is an independent risk factor for the occurrence and development of cardiovascular and cerebrovascular diseases, endocrine diseases and chronic kidney diseases.[2] It has been reported that patients with gout continue to have microinflammation in their bodies even during the intermission period between attacks, and chronic low-grade inflammation is the basis of metabolic. Pak J Med Sci September - October 2020 Vol 36 No 6 www.pjms.org.pk 1334 syndromes, such as obesity, hyperlipidemia, and atherosclerosis.[3] A large number of studies have shown that rheumatoid arthritis, which is a rheumatic immune disease, has a significantly increased risk of carotid plaque formation and cardiovascular events.[4,5] Early treatment with statins can effectively improve lipid metabolism and inflammation indexes and reduce mortality. The purpose of this study was to provide more evidence to guide clinical treatment
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