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

非布索坦 医学 别嘌呤醇 痛风 嘌呤 高尿酸血症 嘌呤代谢 尿酸 内科学 药理学 生物化学 生物
作者
Xuejiao Chen,Ye Tao,Yuna Dai,Pian Li,Xiaodong Zhao,Yanfang Yu,Xiaoliang Wang,Xiaoya Jiao,Na Shen
出处
期刊:International Journal of Rheumatic Diseases [Wiley]
卷期号:27 (5)
标识
DOI:10.1111/1756-185x.15165
摘要

Abstract Objective 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. Method s 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. Results 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). Conclusion 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.
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