Effects of urate-lowering therapy on inflammatory responses, gout flares occurances, and the achieved target rate of serum uric acid in acute gout

Abstract

Objective To observe the effects of urate-lowering therapy (ULT) on indexes of inflammation, the frequency of gout flares, compliance of ULT, and the achieved rates of serum uric acid in patients at acute stage. Methods 151 patients with acute gout flares were randomly divided into observation group (60 cases with ULT in the acute phase) and control group (91 cases with ULT after 2 weeks of complete remission from acute flares). Visual analogue pain scores (VAS), joint swelling scores, white blood cell counts, erythrocyte sedimentation rates (ESR), as well as high sensitive-C reactive protein (hs-CRP) were measured respectively and compared between two groups. The observation group was treated with 40 mg/d of febuxostat for 12 weeks after effectively achieved inflammation (VAS<3 points), while the control group was treated with the same therapy after 2 weeks of symptoms complete remission from acute gout flares. Finally, these indexes were followed and recorded, including the number of gout flares, the compliance of ULT, the changes of liver and kidney function, and the proportion of patients with serum uric acid<360 μmol/L. Results There was no statistical difference in the baseline condition, VAS pain scores, joint swelling scores, white blood cell counts, ESR, and hs-CRP between two groups after different ULTs (all P>0.05). There was no statistical difference in the frequency of gout flares between two groups during the ULT of 12 weeks (P=0.658). At the end of 12 weeks, the serum uric acid in the observation group was significantly lower compared with the control group [(318.38±95.16 vs 398.12±120.13)μmol/L, P<0.01]. The compliance rate of ULT and the rate of reaching the standard of serum uric acid<360 μmol/L in the observation group were higher than those in the control group (both P<0.01). Conclusion The treatment of ULT with patients after effective achieved of acute gout inflammation has no detrimental effects on VAS pain, joint swelling score, the conversion of inflammation index, and the number of gout flares, while improving the compliance of ULT and the achieved rate of serum uric acid. Key words: Acute gout; Urate-lowering therapy; Indexes of inflammation; Achieved rate of serum uric acid