Association between the initial dose urate-lowering drugs and gout flares in adult males with gout

作者：Xiaoli Li, Qin Shao, Jingfang Shen, Shaohui Ren, Lianju Li, Hua Rong Lu, Shubo Chen · 发表于：Lara D. Veeken · 年份：2023 · DOI：10.1093/rheumatology/kead437 · 被引用次数：2 · 研究领域：Gout, Hyperuricemia, Uric Acid、Thyroid Disorders and Treatments、Medicinal plant effects and applications

OBJECTIVES: Frequent gout attacks in the initial introduction of urate-lowering therapy (ULT) are significant causes of poor drug adherence and ULT discontinuation. Initial low-dose urate-lowering drugs may be effective in reducing gout flares, however robust evidence is sparse. The aim of this study was therefore to assess the association of initial dose urate-lowering drugs with gout flares in adult males with gout during the initial introduction of ULT. METHODS: This cohort study obtained data on consecutive gout patients from a single-centre gout cohort study from August 2017 to October 2020. A standard questionnaire was applied to collect demographic and clinical information, and biochemical parameters were tested on the same day. The primary endpoint was to estimate the association of initial dose febuxostat with gout flares, using Cox hazard models with inverse probability of treatment weighting (IPTW). RESULTS: A total of 582 gout patients were included in this study. During the 6-week follow-up, 71 (12.2%) patients suffered gout flares. In the main analysis using Cox hazard models with IPTW, compared with colchicine prophylaxis, initial low-dose febuxostat alone had no statistical significance with the increased risk of gout flares [hazard ratio (HR) 1.26; 95% CI 0.58, 2.72], while initial high-dose febuxostat was associated with an increased risk of gout flares (HR 3.08; 95% CI 1.34, 7.07). CONCLUSIONS: This observational study demonstrated that initial low-dose feb...