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  • Li, Xinde  (3)
  • Terkeltaub, Robert  (3)
  • 2020-2024  (3)
  • Medicine  (3)
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  • 2020-2024  (3)
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  • Medicine  (3)
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  • 1
    In: Arthritis Care & Research, Wiley, Vol. 76, No. 5 ( 2024-05), p. 703-711
    Abstract: There is an unmet need for simpler urate‐lowering therapy (ULT) regimens that achieve the serum urate target and improve the overall quality of gout care. We report a comparative effectiveness trial of febuxostat monotherapy versus benzbromarone add‐on to low‐dose febuxostat in gout specifically with combined renal urate underexcretion and overload. Methods A prospective randomized trial was conducted on patients with combined‐type hyperuricemia and estimated glomerular filtration rate 〉 60 mL/min/1.73 m 2 1:1 randomly assigned to febuxostat and benzbromarone combination therapy (initially febuxostat at 20 mg/day, with benzbromarone at 25 mg/day added onto 20 mg/day of febuxostat if not at target) or febuxostat monotherapy (initially 20 mg/day, escalating to 40 mg/day if not at target). The primary end point at 12 weeks was the proportion achieving a serum urate (SU) level 〈 360 μmol/L. Other outcomes included altered liver and kidney function, new‐onset urolithiasis, and gout flares. Results There were 250 participants randomized; 219 completed 12‐week treatment. More patients in the febuxostat and benzbromarone combination group achieved the SU target compared to patients in the febuxostat monotherapy group (75.5% vs 47.7%; odds ratio 3.37 [95% confidence interval 1.90–5.98]). Safety profiles were comparable between the two groups. Conclusion Simply adding on low‐dose benzbromarone (25 mg/day) to low‐dose (20 mg/day) febuxostat showed superior urate lowering compared to febuxostat monotherapy in gout with a combined‐type hyperuricemia. For selected patients, expedited achievement of the SU target in more than 75% of patients using one titration step and low xanthine oxidase inhibitor and uricosuric doses is a potential alternative to standard ULT regimens.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2016713-1
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  • 2
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. 8 ( 2022-08), p. 1189-1193
    Abstract: COVID-19 vaccination often triggers a constellation of transitory inflammatory symptoms. Gout is associated with several comorbidities linked to poor outcomes in COVID-19, and gout flares can be triggered by some vaccinations. We analysed the risk of gout flares in the first 3 months after COVID-19 vaccination with inactivated virus, and whether colchicine can prevent gout flares following post-COVID-19 vaccination. Methods A clinical delivery population-based cross-sectional study was conducted in the Gout Clinic at the Affiliated Hospital of Qingdao University between February and October 2021. Study participants were selected using a systematic random sampling technique among follow-up patients with gout. We collected data, including vaccinations and potential risk factors, using a combination of interviews, health QR codes and medical records. Logistic regression was used to adjust for covariates. Results We enrolled 549 gout participants (median age 39 years, 84.2% vaccinated). For the 462 patients who received COVID-19 vaccine, 203 (43.9%) developed at least one gout flare in the 3 months after vaccination. Most of these flares were experienced within 1 month after the first (99/119 (83.2%)) or second (70/115 (60.9%)) dose of vaccine. Compared with unvaccinated participants, COVID-19 vaccination was associated with higher odds of gout flare within 3 months (adjusted OR 6.02; 95% CI 3.00 to 12.08). Colchicine use was associated with 47% less likelihood of postvaccine gout flare. Conclusion COVID-19 vaccination was associated with increased odds of gout flare, which developed mainly in month 1 after each vaccine dose, and was negatively associated with colchicine prophylaxis.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    RVK:
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1481557-6
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  • 3
    In: Arthritis Care & Research, Wiley
    Abstract: To assess post‐COVID‐19 vaccination gout flare risk with differing baseline flare burden. Methods We prospectively studied gout patients with infrequent or frequent flares, defined as ≤1 flare/year, or ≥2 flares/year, respectively. COVID‐19 vaccine‐naïve patients managed with urate‐lowering therapy between February‐June 2021were included, and voluntarily decided on vaccination. Participants were followed for 12 weeks after enrollment or first vaccine dose. Gout flares and risk factors were compared between groups. Results Of 530 participants, 308 (58.1%) had infrequent flares, and 222 (41.9%) had frequent flares at baseline, with 248 (142 infrequent, 106 frequent) receiving two‐dose COVID‐19 vaccination. Vaccination increased cumulative flare incidence at 12 weeks in the infrequent but not the frequent flare group (26.1% vs. 10.8%, P =0.001, compared to 60.4% vs. 65.5%, P =0.428). Flare incidence in the final 4 weeks of observation decreased significantly only in the vaccinated infrequent flare group (4.3% vs. 12.0%, P =0.017). Multivariable analyses showed that vaccination (OR=2.82, 95%CI 1.50‐5.30, P =0.001), flare in the preceding year (OR=1.95, 95%CI 1.03‐3.71, P =0.04) and BMI (OR=1.09, 95%CI 1.01‐1.19, P =0.03) were independently associated with increased flare risk in the infrequent flare group. Baseline serum urate (mg/dL) was an independent risk factor in the frequent flare group (OR=1.23, 95%CI 1.05‐1.45, P =0.012). Conclusion COVID‐19 vaccination was associated with increased early gout flares only in patients with previously infrequent flares. image
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2016713-1
    Location Call Number Limitation Availability
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