TREATMENT EFFICACY OF URATE-LOWERING THERAPY WITH THE USE OF ALLOPURINOL AND FEBUXOSTAT IN PATIENTS WITH GOUT
DOI:
https://doi.org/10.11603/2415-8798.2018.3.9433Keywords:
gout, treatment efficacy, allopurinol, febuxostatAbstract
Gout is the largest joint disease with a different spectrum of clinical manifestation. In addition to recurrent acute arthritis, subcutaneous tophus and chronic pain, it has a significant effect on morbidity and premature mortality as comorbid pathology.
The aim of the study – to evaluate the effectiveness of urate-lowering therapy (ULT) with the use of allopurinol and febuxostat in patients with gout.
Materials and Methods. The study involved 110 patients with gout (100 % men, mean age (52.6±9.6 years). Among the surveyed 37 patients with the presence of tophi. In order to reduce serum uric acid (UA) patients used febuxostat or allopurinol. The effectiveness of the treatment was evaluated after 24 weeks.
Results and Discussion. Under the influence of ULT positive dynamics of clinical and laboratory parameters was noted, but in patients with tophi it was less pronounced. Patients using ULT febuxostat showed better dynamics of indicators such as the frequency of exacerbations of gouty arthritis during the last year, serum UA, activity by GAS, and the intensity of pain by VAS. Also, the probability of achieving the target UA levels in patients receiving febuxostat is three times higher (OR = 3.52; 95 % CI 1.46; 8.45) than in patients using allopurinol.
Conclusions. The use of febuxostat for urate-lowering therapy allows faster achievement of target levels of uric acid and regression of arthrological status.
References
Roddy, E., & Choi, H.K. (2014). Epidemiology of gout. Rheumatic Disease Clinics, 40 (2), 155-175.
Kuo, C.F., Grainge, M.J., Mallen, C., Zhang, W., & Doherty, M. (2016). Comorbidities in patients with gout prior to and following diagnosis: case-control study. Annals of the rheumatic diseases, 75 (1), 210-217.
Richette, P., Doherty, M., Pascual, E., Barskova, V., Becce, F., Castaneda-Sanabria, J., ... & Lioté, F. (2017). 2016 updated EULAR evidence-based recommendations for the management of gout. Annals of the rheumatic diseases, 76 (1), 29-42.
Khanna, D., Fitzgerald, J.D., Khanna, P.P., Bae, S., Singh, M.K., Neogi, T., ... & Kaldas, M. (2013). 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis care & research, 64 (10), 1431-1446.
Khanna, D., Khanna, P.P., Fitzgerald, J.D., Singh, M.K., Bae, S., Neogi, T., ... & Kaldas, M. (2013). 2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis care & research, 64 (10), 1447-1461.
Juraschek, S.P., Kovell, L.C., Miller, E.R., & Gelber A.C. (2015). Gout, Urate-Lowering Therapy, and Uric Acid Levels Among Adults in the United States. Arthritis care & research, 67, 588-592.
Neogi, T., Jansen, T.L., Dalbeth, N., Fransen, J., Schumacher, H.R., Berendsen, D., … & Taylor, W.J. (2015). 2015 gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis & rheumatology, 67 (10), 2557-2568.
Scirè, C.A., Carrara, G., Viroli, C., Cimmino, M.A., Taylor, W.J., Manara, M. … & Minisola, G. (2016). Development and first validation of a disease activity score for gout. Arthritis care & research, 68 (10), 1530-1537.
Cutolo, M., Cimmino, M.A., & Perez-Ruiz, F. (2017). Potency on lowering serum uric acid in gout patients: a pooled analysis of registrative studies comparing febuxostat vs. allopurinol. Eur Rev Med Pharmacol Sci, 21 (18), 4186-4195.
Downloads
Published
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
