Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature reviewReport as inadecuate




Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review - Download this document for free, or read online. Document in PDF available to download.

Rheumatology International

, Volume 36, Issue 12, pp 1747–1752

First Online: 19 October 2016Received: 18 June 2016Accepted: 12 October 2016

Abstract

The aim of this study was to systematically review the literature on effect of initiating urate-lowering treatment ULT during an acute attack of gout on duration of index attack and persistence on ULT. OVID Medline, EMBASE and AMED were searched to identify randomized controlled trials RCTs of ULT initiation during acute gout attack published in English language. Two reviewers appraised the study quality and extracted data independently. Standardized mean difference SMD and relative risk RR were used to pool continuous and categorical data. Meta-analysis was carried out using STATA version 14. A total of 537 studies were selected. A total of 487 titles and abstracts were reviewed after removing duplicates. Three RCTs were identified. There was evidence from two high-quality studies that early initiation of allopurinol did not increase pain severity at days 10–15 SMDpooled 95 % CI 0.18 −0.58, 0.93. Data from three studies suggested that initiation of ULT during an acute attack of gout did not associate with dropouts RRpooled 95 % CI 1.16 0.58, 2.31. There is moderate-quality evidence that the initiation of ULT during an acute attack of gout does not increase pain severity and risk of ULT discontinuation. Larger studies are required to confirm these findings so that patients with acute gout can be initiated on ULT with confidence.

KeywordsAcute gout Urate-lowering treatment Systematic review Electronic supplementary materialThe online version of this article doi:10.1007-s00296-016-3579-z contains supplementary material, which is available to authorized users.

An erratum to this article is available at http:-dx.doi.org-10.1007-s00296-016-3629-6.

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Author: Fatma Eminaga - Jonathan Le-Carratt - Adrian Jones - A. Abhishek

Source: https://link.springer.com/







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