Abstract:
OBJECTIVES:To assess the efficacy and safety of the commonly used urate-lowering therapies (ULTs): febuxostat, allopurinol, and lesinurad in hyperuricemic patients with gout. METHODS:We included all randomized controlled trials (RCTs) that compared ULTs with placebo or head to head. The primary efficacy endpoint was the proportion of subjects achieving the target serum urate (SU) level at month 6. Safety outcomes included total adverse events (AEs), serious AEs, withdrawals due to AEs, and AEs per organ system. A Bayesian network model was used to compare all ULTs with placebo and among themselves. RESULTS:Fifteen RCTs were included for the analysis, in which 7968 patients were randomly assigned to take either placebo or one of 11 ULTs: allopurinol, febuxostat 40/80/120/240 mg/day, lesinurad 400 mg/day, lesinurad 200/400/600 mg/day plus allopurinol, and lesinurad 200/400 mg/day plus febuxostat. All ULTs were effective in achieving the target SU level at month 6 compared with placebo (ORs between 26.81 and 1928). Febuxostat 80/120/240 mg/day was superior to allopurinol and well tolerated for urate reduction. And as febuxostat dosage increased, more patients achieved the target SU level. Furthermore, the lesinurad combination with xanthine oxidase inhibitor (XOI) groups had a higher proportion of patients achieving the target SU level than the febuxostat 40 mg/day group (ORs between 2.89 and 9.17), the allopurinol group (ORs between 3.56 and 11.27), or the lesinurad 400 mg/day monotherapy group (ORs between 12.30 and 39.17) but might have a high risk of AEs. CONCLUSIONS:All ULTs are effective in achieving the target SU level compared with placebo in hyperuricemic patients with gout. Lesinurad in combination with febuxostat or allopurinol is effective in urate lowering, especially for patients with inadequate response to XOI monotherapy. Key Points • All urate-lowering therapies (ULTs) were effective in achieving the target serum urate (SU) level at month 6 compared with placebo in hyperuricemic patients with gout. • Febuxostat 80/120/240 mg/day was superior to allopurinol and well tolerated for urate reduction. And as febuxostat dosage increased, more patients achieved the target SU level. • Lesinurad in combination with febuxostat or allopurinol was effective in urate lowering, especially for patients with inadequate response to xanthine oxidase inhibitor monotherapy, but might have a high risk of AEs.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Fan M,Liu J,Zhao B,Wu X,Li X,Gu J,Schlesinger Ndoi
10.1007/s10067-020-05272-4subject
Has Abstractpub_date
2021-02-01 00:00:00pages
683-692issue
2eissn
0770-3198issn
1434-9949pii
10.1007/s10067-020-05272-4journal_volume
40pub_type
杂志文章abstract::Inflammation of one or both sacroiliac joints is a characteristic feature of patients with spondyloarthropathies (SpA). Sacroiliitis often leads to inflammatory back pain (IBP). IBP and asymmetric peripheral arthritis of the lower limbs are the main clinical symptoms and criteria for classification and diagnosis of Sp...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s100670050011
更新日期:2000-01-01 00:00:00
abstract::Systemic lupus erythematosus (SLE) is a multi-system chronic inflammatory disease with a broad spectrum of clinical and serological manifestations. Although clinical evidence of proximal skeletal muscle involvement is not rare in patients with SLE, there is no knowledge about the effects of SLE on the macroscopic stru...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-013-2249-8
更新日期:2013-08-01 00:00:00
abstract::Although the Health Assessment Questionnaire (HAQ) and the Modified Health Assessment Questionnaire are useful tools for assessing and monitoring patients with rheumatic diseases, they have a "floor effect" and do not fully reflect the psychological status of patients. Recently, the Multidimensional Health Assessment ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-005-0049-5
更新日期:2006-05-01 00:00:00
abstract::The study aimed to determine the serum level of glucocorticoid-induced tumor necrosis factor receptor family-related protein ligand (GITRL) in patients with rheumatoid arthritis (RA) and investigate its clinical significance. GITRL levels were measured by enzyme-linked immunosorbent assay (ELISA) in 88 RA patients, 20...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-016-3280-3
更新日期:2016-09-01 00:00:00
abstract::In juvenile chronic arthritis (JCA) the indices of disease activity, such as joint swelling, pain, tenderness, and limitation of motion, may poorly correlate with the degree of functional impairment. Since the improvement of functional capacity is one of the main objectives of treatment, we evaluated the effect of met...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02208347
更新日期:1995-05-01 00:00:00
abstract::The objective of this study was to determine tendon involvements and enthesal abnormalities in patients with rheumatoid arthritis (RA) using high-resolution ultrasonographic images and to compare the findings with those seen in patients with ankylosing spondylitis (AS) and healthy controls. A total of 24 patients with...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-004-0997-1
更新日期:2005-06-01 00:00:00
abstract::The objective of the study was to analyze the prognostic factors of radiographic progression in a series of patients with early rheumatoid arthritis (RA) after 2 years of therapy with a structured algorithm using disease-modifying antirheumatic drugs (DMARDs) and very low doses of oral glucocorticoids. One hundred and...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/s10067-006-0462-4
更新日期:2007-07-01 00:00:00
abstract::Determine the effect of daily low divided or single daily dose of prednisone on the longitudinal change in the number of tender and swollen joints and HAQ scores in African Americans (AA) with early rheumatoid arthritis (RA) from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid...
journal_title:Clinical rheumatology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10067-017-3943-8
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:This study aimed to investigate the relationship among smoking, TNF-α-blocker therapy, and the dynamic changes in gut microbiota in patients with ankylosing spondylitis (AS). METHODS:Using a 16S rRNA sequence, 98 fecal samples of 20 AS patients collected after 0, 1, 3 and 6 months of anti-TNF-α treatment an...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05032-4
更新日期:2020-09-01 00:00:00
abstract::Physical therapy and exercise (recreational activity) are the cornerstones of non-pharmacologic therapy in axial spondyloarthritis (AxSpA) [1, 2]. These are components of physical activity, though physical activity is made up of activities beyond these and also include occupational activity. Not all activities in AxSp...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-016-3264-3
更新日期:2016-06-01 00:00:00
abstract::To explore whether femoral cartilage thickness is related (and changes) with muscle strength in subjects with knee osteoarthritis (OA). Forty patients (27 F, 13 M) with knee OA-who were under quadriceps muscle strengthening program-were enrolled in the study. Isokinetic/isometric knee muscle strength measurements (at ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-016-3271-4
更新日期:2016-08-01 00:00:00
abstract::Circulating intercellular adhesion molecule-1 (ICAM-1) and 3 types of autoantibodies were measured in 30 patients with angiographical or pathological proved vasculitis. There were 18 patients with systemic vasculitis and 12 patients with cutaneous vasculitis. The measured antibodies included anti-endothelial cell anti...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02231583
更新日期:1993-09-01 00:00:00
abstract::Amyloid arthropathy is said to be distinguished roentgenographically from rheumatoid arthritis by the absence of joint space narrowing and the absence of articular erosions. We present a patient with multiple myeloma with swelling, stiffness and firm synovial thickening of the wrists, metacarpophalangeal joints and pr...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02032296
更新日期:1985-06-01 00:00:00
abstract::This study aims to examine the needs and preferences regarding the delivery of health care services and information provision and their determinants in patients with systemic sclerosis (SSc). A questionnaire was sent to 77 SSc outpatients, comprising 27 items on health care needs within the domains physical, psycholog...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-010-1645-6
更新日期:2011-06-01 00:00:00
abstract::The effects of vitamin C on 1,25(OH)2D3 synthesis in humans were evaluated; the study included 20 females. They were divided into 2 groups. The first of the 10 subjects (age range 55-71) received ascorbic acid at a dose of 150 mg/die i.v. for 10 days; the second 10 subjects (age range 55-69) received a placebo i.v. fo...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02207657
更新日期:1991-06-01 00:00:00
abstract::Sjögren's syndrome is characterized serologically by the presence of autoantibodies against Ro/SS-A and La/SS-B. The mechanisms by which these autoantibodies arise is not clear at this moment. B cells capable of producing antibodies to Ro/SS-A and La/SS-B seem to be present in every individual; whether or not an indiv...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/BF03342632
更新日期:1995-07-01 00:00:00
abstract::The aim of this study is to compare effectiveness and safety of Infliximab (INF), Etanercept (ETN), and Adalimumab (ADA) in patients with psoriatic arthritis (PsA) with inadequate response to a previous disease-modifying antirheumatic drug (DMARD). One hundred consecutive PsA patients with inadequate response to a pre...
journal_title:Clinical rheumatology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10067-009-1340-7
更新日期:2010-04-01 00:00:00
abstract::This paper presents the first reported case of risedronate-associated scleritis and conducts a review of bisphosphonates and inflammatory eye diseases. A case of scleritis associated with risedronate use in a 73-year-old Chinese woman is reported. The English medical literature was reviewed for bisphosphonates and the...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-012-2035-z
更新日期:2012-09-01 00:00:00
abstract::Distinction between infection and febrile disease flare in patients with systemic lupus erythematosus (SLE) is fundamental but often difficult to make, because clinical presentation can be similar. A systematic review of all articles indexed in PubMed through October 2013 was performed, in order to examine the potenti...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-014-2738-4
更新日期:2014-09-01 00:00:00
abstract::We investigated, in retrospect, if there were differences in the frequency and types of abdominal surgery between newly diagnosed female fibromyalgia (n = 80) and rheumatoid arthritis (n = 47) patients performed before the formal diagnosis. There was no difference in the total number of abdominal operations between bo...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s100670050042
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:The objectives of our study were to compare the efficacy of febuxostat with allopurinol in Thai subjects with gout, as well as to determine the predictive factors of responsiveness to urate-lowering agents and to evaluate the safety of febuxostat in a real-world setting. METHODS:The study was a retrospective...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05262-6
更新日期:2021-01-01 00:00:00
abstract::The immunoinflammatory pathogenesis of juvenile chronic arthritis (JCA) involves the activation of many pathways including various cytokines. We have evaluated the levels of interleukin(IL)-1, IL-6 and IL-8 in 29 JCA patients. The age range was 1-16 with a mean of 10.1. A disease activity score was developed on the ba...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02247847
更新日期:1997-03-01 00:00:00
abstract:INTRODUCTION/OBJECTIVES:We hypothesized that mechanical compression of the knee in rheumatoid arthritis (RA) would mobilize occult extractable fluid and improve arthrocentesis success. METHODS:Sixty-seven consecutive knees with RA and 186 knees with OA and were included. Conventional arthrocentesis was performed and s...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04524-2
更新日期:2019-08-01 00:00:00
abstract::A few studies have reported the safety profile of interleukin (IL)-1 blockers from real life. The aim of this study is to describe anakinra (ANA) and canakinumab (CAN) safety profile in children and adults, based on data from a real-life setting. Demographic, clinical, and therapeutic data from patients treated with A...
journal_title:Clinical rheumatology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10067-018-4119-x
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To assess whether systemic sclerosis (SSc) is associated with total knee arthroplasty (TKA) outcomes. METHODS:We used the 1998-2014 US National Inpatient Sample. We conducted multivariable-adjusted logistic regression analyses to examine the association of a diagnosis of SSc with post-TKA in-hospital complic...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04754-4
更新日期:2020-01-01 00:00:00
abstract::The acute renal side-effects of nonsteroidal anti-inflammatory drugs are well documented. These include interstitial nephritis, hyperkalaemia, renal tubular acidosis, fluid retention, hypertension and nephrotic syndrome. The long-term effects are less well known. We have carried out a cross-sectional survey of an unse...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02204466
更新日期:1988-06-01 00:00:00
abstract::Pain is a leading cause of morbidity worldwide, with published data showing its prevalence as high as 50% for chronic pain in the European population. This prevalence is likely to continue to rise, particularly in elderly people with comorbid conditions and complex aetiologies of pain. There is thus a rapidly growing ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-006-0311-5
更新日期:2006-01-01 00:00:00
abstract::This study demonstrates whether serum β2-microglobulin (β2-MG) level can be an indicator of the status of systemic lupus erythematosus (SLE) and adult-onset Still's disease (AOSD), and development of hemophagocytic syndrome (HPS) complication. Serum β2-MG level was compared between the active and inactive statuses of ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-013-2220-8
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Studies conducted by various scientific societies have shown that the demand for specialized rheumatology care is greater than the projected growth of the workforce. Our research aims to assess the current status of the rheumatology workforce in Latin America. METHOD:This is a descriptive, cross-sectional...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05555-w
更新日期:2021-01-15 00:00:00
abstract:OBJECTIVE:To investigate the clinical characteristics, laboratory features, and treatment outcomes of Thai patients compared between those with necrotizing autoimmune myopathy (NAM) and those with other idiopathic inflammatory myopathies (IIMs) or non-NAM. METHODS:This multicenter case-control study included patients ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10067-019-04756-2
更新日期:2019-12-01 00:00:00