Gout Patients Research Articles

Assessment of electronic health literacy and its association with self-management among gout patients: A cross-sectional study.

This study aimed to assess electronic health (eHealth) literacy and self-management ability among gout patients in China and analyze their correlation. A cross-sectional study was conducted on 168 male gout patients (mean age: 44.5±13.8 years, range, 22 to 76 years) using a gout patient self-management assessment scale and the Chinese version of eHealth Literacy Scale between August 2020 and February 2021. The correlation between eHealth literacy and gout self-management was examined. Multivariate regression analysis was conducted to identify the predictors of gout patients' self-management ability. The scores of eHealth literacy and self-management were 28.56±1.72 and 3.59±0.78, respectively, which were both in the medium level, with the lowest score in the lifestyle management dimension. Pearson's correlation analysis showed that eHealth literacy was significantly and positively associated with the total score of gout self-management and its four dimensions. Literacy in eHealth (β=0.399, p<0.001, 95% confidence interval [CI]: 0.023-0.069), living with family members (β=0.336, p=0.001, 95% CI: 0.313-1.234), living in an urban area (β=0.312, p=0.005, 95% CI: 0.191- 1.022), and having college or a higher level of education (β=0.268, p=0.016, 95% CI: 0.032-0.302) were the significant predictors of gout patients' self-management ability, explained 30.6% of the total variance. Literacy in eHealth was the most significant predictor of gout self-management ability. Gout patients had the lowest score in the perceived ability of searching and applying online health-related information, indicating that both the quantity and quality of gout-specific information needs to be enlarged in electronic resources. Healthcare providers could design and implement eHealth literacy interventions to strengthen patients' gout self-management ability.

Inhibitory capacity of xanthine oxidase, and anticancer activity of compounds from Sarcandra glabra (Thunb.) Nakai flower

The flower of Sarcandra glabra (Thunb.) Nakai (FSN) has been considered an important supplementation material in natural flower-flavoured tea products in Vietnam. The present work has considerable significance for adding pharmacological value of FSN. Two compounds, namely emodin and methyl rosmarinate, were identified for the first time from a methanolic extract of FSN from Vietnam while analysing the inhibitory capacity of xanthine oxidase and cytotoxic activities. High levels of xanthine oxidase inhibiting capacity and cytotoxicity activity against HepG2 and A549 cancer cell lines were detected from emodin, with IC50 of 4.88 ± 0.42, 13.72 ± 0.48, and 18.33 ± 0.10 µg/mL, respectively. Emodin also activated the apoptotic factors of caspase-9, Bax, and PARP in HepG2, and caspase-3/9 and p53 in A549. Our results revealed for the first time the xanthine oxidase inhibitory effect of M70 with IC50 of 34.15 ± 1.33 µg/mL, which would shed light on its potential application for developing anti-hyperuricemia agents. The present work suggested that using flower-flavoured tea product of FSN could have many health benefits for gout patients.

Identification of Anastatica hierochuntica L. Methanolic-Leaf-Extract-Derived Metabolites Exhibiting Xanthine Oxidase Inhibitory Activities: In Vitro and In Silico Approaches.

There is a growing interest in the discovery of novel xanthine oxidase inhibitors for gout prevention and treatment with fewer side effects. This study aimed to identify the xanthine oxidase (XO) inhibitory potential and drug-likeness of the metabolites present in the methanolic leaf extract of Anastatica (A.) hierochuntica L. using in vitro and in silico models. The extract-derived metabolites were identified by liquid-chromatography-quadrupole-time-of-flight-mass-spectrometry (LC-QTOF-MS). Molecular docking predicted the XO inhibitory activity of the identified metabolites and validated the best scored in vitro XO inhibitory activities for experimental verification, as well as predictions of their anticancer, pharmacokinetic, and toxic properties; oral bioavailability; and endocrine disruption using SwissADMET, PASS, ProTox-II, and Endocrine Disruptome web servers. A total of 12 metabolites, with a majority of flavonoids, were identified. Rutin, quercetin, and luteolin flavonoids demonstrated the highest ranked docking scores of -12.39, -11.15, and -10.43, respectively, while the half-maximal inhibitory concentration (IC50) values of these metabolites against XO activity were 11.35 µM, 11.1 µM, and 21.58 µM, respectively. In addition, SwissADMET generated data related to the physicochemical properties and drug-likeness of the metabolites. Similarly, the PASS, ProTox-II, and Endocrine Disruptome prediction models stated the safe and potential use of these natural compounds. However, in vivo studies are necessary to support the development of the prominent and promising therapeutic use of A. hierochuntica methanolic-leaf-extract-derived metabolites as XO inhibitors for the prevention and treatment of hyperuricemic and gout patients. Furthermore, the predicted findings of the present study open a new paradigm for these extract-derived metabolites by revealing novel oncogenic targets for the potential treatment of human malignancies.

Perfect Timing for Canakinumab Use in Gout

Gout is an inflammatory disease caused by the deposition of monosodium urate (MSU) crystals. Recently, the American College of Rheumatology (ACR) has recommended the usage of interleukin (IL)-1 inhibitor in gout patients who are refractory to typical anti-inflammatory drugs. An example of IL-1 inhibitor is canakinumab. Not much is known regarding the usage of canakinumab in gout arthritis. Thus, we decided to conduct a narrative review that summarizes the efficacy and safety of canakinumab in gout patients. In this review, we found that canakinumab is superior to non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in treating acute gout flares. In addition, canakinumab may also be considered as a preventive therapy for gout flares in patients receiving urate-lowering therapy. Overall, canakinumab has mild side effects but may occasionally cause serious infections. Canakinumab is also generally safe for use during pregnancy. Due to the lack of studies, the safety of canakinumab in lactating women, geriatric patients, and patients with hepatic or renal impairment is still unknown.

Estimation of Hair Toxic and Essential Trace Element and Mineral Profiles of Patients with Chronic Gout.

The objective of the present study was to evaluate hair levels of toxic and essential trace elements and minerals in male and female patients with chronic gout. A total of 223 examinees aged from 27 to 82years old including 116 healthy controls (64 women and 52 men) and 107 patients with gout (56 women and 51 men) were enrolled in the current cross-sectional study. Analysis of hair toxic and essential trace element and mineral content was performed using inductively-coupled plasma mass-spectrometry. The obtained data demonstrate that hair B, Fe, I, and Mo levels in gout patients were 67%, 8%, 46%, and 21% higher in comparison to the respective control values. Hair Cr and V content in patients was more than twofold higher than in the controls. Hair Mg and Zn levels were found to be 34% and 11% lower when compared to the respective control values. Hair toxic metal and metalloid content was also significantly affected in gout patients. Specifically, hair Al, As, and Pb levels were 24%, 43%, and 33% higher in gout patients than in healthy controls, respectively. Analysis of covariance demonstrated that sex also had a significant influence on hair trace element and mineral levels in gout patients. Specifically, gout-associated overaccumulation of hair trace elements including was more profound in male than in female patients. It is assumed that trace element dysregulation may contribute to gout development and progression, especially in men. However, further studies are required to elucidate this association and the underlying molecular mechanisms.

The effect of exercise rehabilitation with exergames combined with ice therapy in the treatment of obese patients with gout: protocol for a clinical trial

BackgroundGout remains a leading cause of inflammatory arthritis worldwide, and the main risk factor for gout is persistent hyperuricemia. The clinical management of gout is mostly drug-based, and other treatment options are often ignored. This research proposal will explore whether exergames combined with ice therapy can help patients with gout to lose weight, relieve pain, improve the range of movement, improve quality of life, decrease uric acid level, decrease kinesiophobia and improve mental health of patients with gout.MethodsThis experiment will use a two-arm randomized controlled design. The study setting is at the Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia (USM). Obese patients with gout (N = 30) will be randomly assigned to the control group (receive an exergames intervention) and intervention group (receive an exergames intervention combined with ice therapy). The outcomes measurement will be conducted before (baseline) and after intervention (4 weeks). Then, it will be followed up at 12 weeks.DiscussionTo our knowledge, no study has investigated the effect of exergames and ice therapy among gout patients. This study is expected to demonstrate that exercise rehabilitation facilitated by exergames with ice therapy is more effective in gout management compared to a conventional rehabilitation intervention.Trial registrationChinese Clinical Trial Registry (ChiCTR2300070029). Registered on 31 March 2023.

Mechanism of neutrophil extracellular traps in the pathogenesis of gout.

Gout is a self-limited inflammatory disease caused by the deposition of monosodium urate (MSU) crystals in joints and surrounding tissues due to abnormal purine metabolism. Neutrophil extracellular traps (NETs) are formed by neutrophils in response to pathogen attack. During gout, NETs induced by MSU crystals exacerbate inflammation, and aggregated NETs (aggNETs) promote the resolution of gout-associated inflammation by encapsulating MSU crystals, degrading cytokines and chemokines, and blocking the recruitment and activation of neutrophils. With disease progression, NETs participate in the formation of tophi. Therefore, aggNETs are a possible mechanism of spontaneous gout regression. Studying the specific mechanism by which NETs affect inflammatory bursts and spontaneous regression in gout patients is important. This review summarises the role of NETs in different stages of gout and the specific pathogenesis of NETs in gout to provide new ideas for the diagnosis and treatment of gout.

Battle of the strategies: diet versus drug therapy for gout

The best results in combating gout are achieved through a combination of diet and drug therapy. Urate-lowering therapy, which includes febuxostat, has been shown to be more effective and convenient than diet when it comes to achieving and maintaining target uric acid (UA) levels in gout patients. Febuxostat, a xanthine oxidase inhibitor, helps to reduce UA levels in the blood by blocking its formation. This helps prevent the deposition of urate crystals in joints and tissues and reduces the frequency and severity of gout attacks. At the same time, a diet of low purine foods may also have some effect on UA levels. Diet can improve the results of drug treatment by reducing the need for medications and minimizing the risk of side effects. However, without adequate drug therapy, diet will not produce the desired results. Therefore, febuxostat remains the preferred urate-lowering treatment option for gout, especially given its proven efficacy in these patients.

Projected Health and Economic Burden of Comorbid Gout and Chronic Kidney Disease in a Virtual US Population: A Microsimulation Study.

Gout, a common comorbidity of chronic kidney disease (CKD), is associated with high morbidity and healthcare utilization. However, a large proportion of gout remains undermanaged or untreated which may lead to worse patient outcomes and greater healthcare costs. This study estimates the present and future health and economic burden of controlled and uncontrolled gout in a virtual United States (US) CKD population. A validated microsimulation model was used to project the burden of gout in patients with CKD in the USA through 2035. Databases were utilized to build a virtual CKD population of "individuals" with controlled or uncontrolled gout. Modelling assumptions were made on the basis of the literature, which was sparse in some cases. Health and economic outcomes with the current care (baseline) scenario were evaluated, along with potential benefits of urate-lowering intervention scenarios. The prevalence of comorbid gout and CKD in the USA was projected to increase by 29%, from 7.9 million in 2023 to 9.6 million in 2035 in the baseline scenario. Gout flares, tophi, and comorbidity development were also projected to increase markedly through 2035, with the economic burden of gout in the CKD population subsequently increasing from $38.9 billion in 2023 to $47.3 billion in 2035. An increased use of oral urate-lowering therapies in undermanaged patients, and pegloticase use in patients refractory to oral urate-lowering therapies were also project to result in 744,000 and 353,000 fewer uncontrolled gout cases, respectively, by 2035. Marked reductions in complications and costs ensued. This study projected a substantial increase in comorbid gout and CKD. However, improved use of urate-lowering interventions could mitigate this growth and reduce the health and economic burdens of gout.

Health-related quality of life in gout patients in Madinah Region, Saudi Arabia

ABSTRACT Background: Gout can significantly impact health-related quality of life (HRQoL) due to excruciating pain, chronic arthropathy, and associated comorbidities. The objective of our study was to evaluate HRQoL among patients diagnosed with gout in the Madinah region of Saudi Arabia. Materials and Methods: The research took place in the Madinah Region, where eligible adult participants aged 18 years or older, having a confirmed history, or present diagnosis of gout were enrolled using medical records from 2016 to 2022. To gather data, patients were invited to participate in telephone-based interviews and complete the Short Form-36 (SF-36) questionnaire. Results: The majority of participants were male (81.5%), and 31–39 years form the largest group (37.0%). Most participants were married (86.4%), and the majority possess university and postgraduate education (70.4%). The respondents’ self-reported assessments were as follows: physical function (69.9), limitation due to physical health (74.1), emotional problem (75.8), energy or fatigue (61.6), emotional well-being (68.9), social functioning (76.6), pain (78.9), and general health (63.8). Conclusions: HRQoL among patients with gout was not significantly affected.

Clinical implications of persistent joint pain after gout flare

ObjectivesA subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis. MethodsWe analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares. ResultsA total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (P<0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% vs. 21.1%) and bone erosion (18.6% vs. 8.6%) (P<0.05). Higher UA and lower TBil were found in patients with persistent joint pain (P<0.001). Hypertension (54.9% vs. 38.7%) and metabolic syndrome (58.8% vs. 46.4%) were both more frequent in patients with persistent joint pain (P<0.05). TBil was negatively correlated with the incidence of persistent joint pain (P<0.001, r=−0.190), UA values (P<0.001, r=−0.125), and metabolic syndrome scores (P<0.001, r=−0.192). A correlation curve was fitted using LOESS (locally weighted region). ConclusionPersistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.

Association of Gout with Head and Neck Cancer: Longitudinal Follow-Up Studies Using a National Health Insurance Database in South Korea.

Objective: Previous studies have reported controversial results on the association between gout and the risk of cancer. This study aimed to investigate the relationship between gout and the incidence of head and neck cancer (HNC). Methods: The data of participants who underwent health checkups in 2009 were analyzed using the National Health Insurance Database in South Korea. A total of 14,348 HNC patients and 57,392 control participants were analyzed for a prior history of gout. Overlap weighting was applied, and odds ratios (ORs) of gout for HNC patients were analyzed. The overlap-weighted model adjusted for demographic, socioeconomic, and lifestyle factors and comorbidities. HNC sites were classified as oral cavity cancer, oropharyngeal cancer, nasopharyngeal cancer, hypopharyngeal cancer, nasal cavity/sinus cancer, larynx cancer, or salivary gland cancer, and the ORs of gout were estimated for each site. Results: Overall, patients with HNC had 1.12-fold greater odds of having gout (95% confidence intervals [CIs] = 1.04-1.20). According to the site of HNC, oral cavity cancer, oropharynx cancer, and larynx cancer demonstrated high odds of having gout (OR = 1.25, 95% CI = 1.16-1.34 for oral cavity cancer; OR = 1.08, 95% CI = 1.01-1.15 for oropharynx cancer; and OR = 1.12, 95% CI = 1.06-1.20 for larynx cancer). On the other hand, nasal cavity/sinus cancer, nasopharynx cancer, and salivary gland cancer presented low odds of having gout (OR = 0.78, 95% CI = 0.72-0.84 for nasal cavity/sinus cancer; OR = 0.89, 95% CI = 0.83-0.96 for nasopharynx cancer; and OR = 0.88, 95% CI = 0.81-0.96 for salivary gland cancer). Conclusions: A prior history of gout was associated with a high overall incidence of HNC. Oral cavity cancer, oropharynx cancer, and larynx cancer have a high incidence in gout patients. However, nasal cavity/sinus cancer, nasopharyngeal cancer, and salivary gland cancer have low incidences in gout patients. The impact of gout on HNC risk should be specifically considered according to the site of the HNC.

Skeletal muscle mass and quality in gout patients versus non-gout controls: A computed tomography imaging study

ObjectivePatients with gout are at elevated risk of multiple vascular and metabolic comorbidities. Whether they are also at risk of sarcopenia, which is known to affect patients with other rheumatic diseases, has not been previously assessed. We examined whether patients with gout have decreased lumbar muscle quality and quantity, indicating an association between gout and sarcopenia. MethodsFifty gout subjects and 25 controls, ages 45–80, underwent computed tomography imaging of the lumbosacral spine. We measured muscle quantity (skeletal muscle area [SMA] and index [SMI]) and quality (skeletal muscle radiation attenuation [SMRA] and intermuscular adipose tissue [IMAT] area and index [IMATI]) of the psoas and erector spinae muscles at the L3 level. ResultsSeventy subjects (45 gout and 25 controls) were included in the analysis. Gout subjects had higher BMI, more kidney disease and hypertension, lower exercise frequency, and higher mean serum urate and creatinine vs. controls. Lumbar SMRA was significantly lower in gout subjects vs. controls, indicating reduced muscle quality. Lumbar IMAT area was significantly higher in gout subjects vs. controls, as was lumbar IMATI, indicating increased muscle adiposity. These differences persisted after adjusting for potential confounders. In contrast, there was no significant difference between gout and control groups in lumbar SMA or lumbar SMI, suggesting that muscle quantity may not be routinely affected by the diagnosis of gout. ConclusionsGout patients exhibit decreased lumbar muscle quality compared with controls, consistent with an association between gout and sarcopenia.

Risk of urolithiasis associated with allopurinol versus benzbromarone among patients with gout: a population-based cohort study.

To compare the risk of urolithiasis in gout patients initiating allopurinol, a xanthine oxidase inhibitor, vs benzbromarone, a uricosuric. Using the 2011-20 Korea National Health Insurance Service database, we conducted a cohort study on gout patients initiating allopurinol vs benzbromarone as the first-line urate-lowering treatment. The primary outcome was a new onset urinary stone. The secondary outcome was a stone requiring intervention. We estimated hazard ratios (HRs) and 95% CIs using Cox proportional hazard models with a 5:1 ratio propensity-score matching on >80 variables. Subgroup analyses were done by age, sex, thiazide use and cardiovascular risk. 61 300 allopurinol initiators PS-matched on 12 260 benzbromarone initiators were included (mean age 59 years, 79% male). During a mean follow-up of 322 days, 619 urolithiasis cases occurred with an incidence rate of 0.87 per 100 person-years in allopurinol and 1.39 in benzbromarone initiators, showing a HR of 0.64 (95% CI, 0.51-0.80). Approximately 44% of urinary stones required intervention with a HR of 0.61 (95% CI, 0.43-0.88). The lower risk associated with allopurinol compared with benzbromarone persisted across subgroups but was greater in the high than non-high cardiovascular risk subgroup (P for interaction = 0.02). This population-based cohort study found that allopurinol compared with benzbromarone was associated with a substantially lower risk of urolithiasis particularly in the presence of the high cardiovascular risk. This finding provides important safety information for clinicians' decision-making on urate-lowering treatments of different mechanisms of action.

Health literacy in patients with gout: A latent profile analysis

Objectives Understanding the health literacy status of patients with gout diagnosis is essential for improving the health of this population. Our study aimed to investigate the latent profiles of health literacy in patients with gout and to analyze differences in characteristics across potential profiles. Methods This was a cross-sectional study. Eligible participants attended the Shandong Gout Medical Center, from March 2023 to May 2023 and self-reported gout diagnosis. We used the Health Literacy Scale for Patients with Gout designed and validated by our team. The scale had good reliability and validity among patients with gout. 243 patients completed the Demographic Information Questionnaire and the Health Literacy Scale for Patients with Gout. We used latent profile analysis to identify the latent profiles of gout patients’ health literacy. We used Chi-square tests with Bonferroni correction to analyze differences in demographics and illness characteristics across identified profiles. Results Three profiles of patients with gout emerged (prevalence): the low literacy-low critical group (21.81%), the moderate literacy group (42.79%), and the high literacy-stable group (35.39%). The three groups differed in age, education level, monthly income, disease duration, and place of residence (P&lt;0.01). Conclusions The health literacy of patients with gout was heterogeneous. Healthcare professionals should adopt targeted interventions based on the characteristics of each latent health literacy profile to improve the health literacy level of patients with gout.

Association between low-density lipoprotein cholesterol levels and serum uric acid to serum creatinine ratio in Chinese male gout patients

This study aimed to evaluate the association between low-density lipoprotein cholesterol (LDL-C) and serum uric acid to serum creatinine (SUA/SCr) ratio in male gout patients at different BMIs. This real-world study included 956 male gout patients aged 18–83 years. We retrospectively analyzed the medical records of Chinese male gout patients from 2017 to 2019. The correlation between LDL-C and SUA/SCr was tested after adjusting for confounding factors. We found a nonlinear relationship between LDL-C and SUA/SCr in the whole study population. Stratification analysis showed that there was actually a nonlinear relationship between LDL-C and SUA/SCr in men with a BMI of 24–28, the inflection point of LDL-C was 1.8 mmol/L, when LDL-C was greater than 1.8 mmol/L, there was a positive correlation between LDL-C levels and SUA/SCr (β = 0.67, 95% CI 0.35–0.98, P < 0.001). Moreover, LDL-C showed a significant positive correlation with SUA/SCr with a BMI of 28 or greater (β = 0.30, 95% CI 0.05–0.55, P = 0.019). However, no association was found between LDL-C and SUA/SCr with a BMI of less than 24 (β = 0.42, 95% CI − 0.03–0.86, P = 0.070). LDL-C levels were associated with SUA/SCr in Chinese male gout patients, but this correlation appeared inconsistent among different BMIs. Our findings suggest that LDL-C levels may be more noteworthy in overweight and/or obese male gout patients.

Comparison of the therapeutic effects of febuxostat combined with a low-purine diet and allopurinol combined with a low-purine diet on the improvement of gout patients.

To compare the clinical efficacy of febuxostat combined with a low-purine diet versus allopurinol combined with a low-purine diet in the treatment of gout. In this prospective controlled trial, 98 gout patients admitted to our hospital from February 2021 to December 2022 were enrolled as study subjects. Patients were randomly assigned to the study group (febuxostat combined with a low-purine diet) and the control group (allopurinol combined with a low-purine diet), with 49 patients in each group. The therapeutic effect was evaluated based on joint function and serum uric acid levels after treatment, and classified into three levels: markedly effective, effective, and ineffective. The levels of inflammatory factors, including tumor necrosis factor-a (TNF-a), cytokine interleukin-1beta (IL-1β), and interleukin (IL)-18 (IL-18), were collected. The Numeric Rating Scale (NRS) was used to assess the degree of pain in patients. Clinical indicators before and 6 months after treatment were compared between the two groups. There was no statistically significant difference in age and gender between the two groups. After 6 months of treatment, the effective rate in the study group (48 cases, 97.96%) was higher than that in the control group (42 cases, 85.71%), with a statistically significant difference (p = .027). At the same time, the study group had significantly lower levels of serum uric acid (162.39 μmol/L ± 17.23 μmol/L vs. S198.32 μmol/L ± 18.34 μmol/L, p < .001), creatinine (87.39 mmol/L ± 9.76 mmol/L vs. 92.18 mmol/L ± 9.27 mmol/L, p = .014), total cholesterol (3.65 mmol/L ± 0.65 mmol/L vs. 4.76 mmol/L ± 0.73 mmol/L, p < .001), and triglycerides (1.76 mmol/L ± 0.32 mmol/L vs. 2.28 mmol/L ± 0.41 mmol/L, p < .001) compared to the control group, with statistically significant differences (p < .05). After treatment, the levels of inflammatory factors and degree of pain in the study group were significantly lower than those in the control group (all p < .05). During the treatment process, the incidence of adverse reactions in the study group (2 cases, 4.08%) was lower than that in the control group (9 cases, 18.37%), with a statistically significant difference (p = .025). Febuxostat combined with a low-purine diet can reduce inflammatory factors and alleviate the degree of pain in gout patients, significantly improving their clinical symptoms.

Therapeutic potential of VBY-825 in MSU crystal-induced NLRP3 inflammasome activation

Abstract In gout patients, MSU crystals formed in the joints cause inflammation, and the activation of the NLRP3 inflammasome is believed to mediate these responses. Cathepsins play an important role in crystal-induced NLRP3 activation that results in subsequent speck formation, caspase-1 activation, IL-1β secretion, and pyroptosis. In this study, we investigated if cathepsins can also influence MSU-induced NLRP3 activation in a gout mouse model. VBY-825 is a reversible pan-cathepsin inhibitor, and we found that VBY-825 significantly suppressed IL-1β secretion and LDH levels from peritoneal naïve macrophages upon MSU stimulation in vito. In a mouse peritonitis model, we found that VBY-825 suppressed MSU-induced inflammation when compared to the control treatment. Interestingly, the inflammation demonstrated by histology and MPO activity in the joints was also reduced by VBY-825 treatment in MSU-induced arthritis. These findings suggest that cathepsins play a critical role in MSU-induced inflammation and could potentially be a target for gout treatment.

Chronic Pain Nursing Care for Elderly Gout Patients Using Warm Water Compress Therapy Combination Lemongrass and Ginger

Introduction: Uric acid is a normal substance found in the body and is the end result of purine metabolism, namely the result of the degradation of purine nucleotides which are important ingredients in the body as components of nucleic acids. The nursing problem that arises in elderly gout patients is chronic pain. The aim of this scientific work aims to explore nursing care for chronic pain in elderly gout patients with warm water compress therapy using lemongrass and ginger at RAAL Griya Asih Lawang.Methods: Using a case study design with nursing care. The subjects of this research were 3 elderly gout patients with chronic pain nursing problems for 3 days, with pain measurement using the Visual Analog Scale (VAS) and SLKI. and the targeted outcome criteria include the ability to complete activities, complaints of pain, protective attitudes, grimacing, restlessness and difficulty sleeping. The instrument used was the UNITRI gerontic nursing care format. Data was analyzed using the SMART method (Specific, Measurable, Achievable, Realistic, Time).Results: From the actions carried out on the three patients for 3 days, it was found that the chronic pain nursing problem in 3 patients was partially resolved with the following criteria: ability to complete activities increased, pain complaints decreased, protective attitude decreased, grimaces decreased, anxiety decreased, difficulty sleeping decreased.Conclusion: Due to limited time in conducting this research, which was only carried out for 3 days, it could affect the results of warm compresses using lemongrass and ginger which could only partially reduce pain complaints.Keywords: chronic pain, gout, warm water compress using lemongrass and ginger.

P084 Gout symptom improvements and patient outcomes with SEL-212 in gout refractory to conventional therapy: DISSOLVE I &amp; II phase 3, double-blind, placebo-controlled clinical trials

Abstract Background/Aims Serum uric acid (sUA) ≥6.8 mg/dL often leads to severe clinical manifestations in gout refractory to conventional therapy. Uricase-based therapies can be effective, although immunogenicity can reduce efficacy and increase infusion-reaction risk. SEL-212 is a novel, once-monthly treatment of sequential infusions of tolerogenic nanoparticles containing sirolimus (SEL-110) followed by a pegylated uricase (pegadricase, SEL-037). DISSOLVE I and II (DI and DII) evaluated the safety/efficacy of SEL-212 in adults with refractory gout. Here we report secondary and key safety endpoints. Methods DI (US) and DII (Global) were placebo-controlled, double-blind, randomised clinical trials that evaluated a combination of SEL-110 at either 0.15 mg/kg [high-dose] or 0.1 mg/kg [low-dose] with SEL-037 (0.2 mg/kg) in refractory gout. Six-month outcomes included sUA reduction, number of tender/swollen joints, tophus burden, health-related quality-of-life, and safety. Results 112 participants (96% male, 66% aged ≥50 years, DI) and 153 participants (97% male, 72% ≥50 years, DII) were dosed (Table 1). Mean age was 55 years, 57% (DI) and 67% (DII) had tophi at baseline, and time since gout diagnosis was 12.9 (DI) and 11.0 years (DII). Both SEL-212 doses significantly reduced mean sUA levels versus placebo over 6-months (5.2-5.6 mg/dL in DI and 3.3-4.5 mg/dL in DII, p &amp;lt; 0.001 for all), with marked reductions during the first-treatment period. In DII, tender joints declined significantly between baseline and six-months in the high- and low-dose groups (8.1 joints, p = 0.003; 9.2 joints, p &amp;lt; 0.001, respectively) versus placebo (4.4 joints). Swollen joints were also significantly reduced with high-dose SEL-212 (5.7 joints, p = 0.013) versus placebo (3.4 joints). There were significant improvements in SF-36 physical component score with both SEL-212 doses versus placebo (p ≤ 0.01), while HAQ-DI was significantly improved with low-dose versus placebo (p = 0.018) in DII. In DI non-statistically significant trends favouring SEL-212 across all secondary endpoints were observed. This may reflect the smaller sample size and milder baseline symptom burden of patients in DI versus DII. Infusion reactions occurred in 3.4% of the combined high-dose groups. Conclusion SEL-212 was well tolerated and provided significant reductions in mean sUA over time, improvement in SF-36 physical and HAQ-DI measures and reduced the number of tender/swollen joints. Disclosure H.S.B. Baraf: Corporate appointments; Sobi, Selecta BioScience, Grünenthal, Fresenius Kabi and Olatec. Member of speakers’ bureau; Horizon Pharmaceuticals. Grants/research support; Horizon Pharmaceuticals, Swedish Orphan Biovitrum. P. Khanna: Consultancies; Horizon, Sobi. Other; Investigator: Selecta Bioscience, Dyve Biosciences. A. Patel: Member of speakers’ bureau; Lexicon Pharmaceuticals. J. Sobierska: Other; Employee of Sobi. J. Christie: Shareholder/stock ownership; GSK Pharma. Other; Employee of Sobi. W. DeHaan: Shareholder/stock ownership; Selecta Biosciences. Other; Employee of Selecta Biosciences. R. Azeem: Shareholder/stock ownership; Selecta Biosciences. Other; Employee of Selecta Biosciences;. P.G. Traber: Shareholder/stock ownership; Selecta Biosciences. Other; Employee of Selecta Biosciences. A. Kivitz: Consultancies; AXDEV Group, Amgen, Pfizer, Janssen, Boehringer Ingelheim, AbbVie, Flexion, Gilead, Grünenthal, Orion, Regeneron, Sun Pharma Advance Research, and ECOR1. Shareholder/stock ownership; Pfizer, GSK, Gilead, Novartis, and Amgen. Member of speakers’ bureau; Merck &amp; Co, Eli Lilly, Novartis, Pfizer, Flexion, AbbVie, Amgen, Genentech, Regeneron, UCB, Horizon, and GSK.