Evaluation of febuxostat initiation during an acute gout attack: A prospective, randomized clinical trial.

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  • Additional Information
    • Source:
      Publisher: Editions Elsevier Country of Publication: France NLM ID: 100938016 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1778-7254 (Electronic) Linking ISSN: 1297319X NLM ISO Abbreviation: Joint Bone Spine Subsets: MEDLINE
    • Publication Information:
      Original Publication: Paris : Editions Elsevier, c2000-
    • Subject Terms:
      Febuxostat*/therapeutic use ; Gout*/drug therapy; Gout Suppressants/adverse effects ; Humans ; Neoplasm Recurrence, Local/drug therapy ; Prospective Studies ; Symptom Flare Up ; Treatment Outcome
    • 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.
      (Copyright © 2020 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.)
    • Contributed Indexing:
      Keywords: Acute gout flare; Evaluation; Febuxostat; Urate-lowering therapy
    • Accession Number:
      0 (Gout Suppressants)
      101V0R1N2E (Febuxostat)
    • Publication Date:
      Date Created: 20200418 Date Completed: 20210625 Latest Revision: 20210625
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.jbspin.2020.03.017
    • Accession Number:
      32302693