在一项为期一年的单中心前瞻性研究中，别嘌呤醇添加到传统越南药物中显示了100名痛风患者的主要改善。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2025-03-15 DOI:10.1016/j.jbspin.2025.105889

Thomas Bardin , Quang Dinh Nguyen , Valérie Bausson , Khoi Tran , Nicola Dalbeth , Chuc Tran , Dai Huynh , Quang Huy Nguyen , Minh Do , Pascal Richette , Matthieu Resche-Rigon

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引用次数: 0

摘要

目的：痛风在越南经常很严重，那里很少使用降尿酸药物（ULDs），许多患者只接受传统草药治疗。我们评估了在越南患者中加入西药治疗严重痛风的效果。方法：在别嘌呤醇起始治疗后，对100名越南无ULD、晶体证实的GFR bb0 60 ml/min的痛风患者进行前瞻性随访1年。治疗方案包括根据2016年EULAR建议给予别嘌呤醇，在头几个月使用秋水仙碱预防耀斑，以及传统草药。在每次访问中，通过每日日记计算痛风耀斑，拍摄数码足部照片进行半定量痛风评分，测量血清尿酸（SU）。超声（US）扫描在基线，6和12个月进行双轮廓（DC）和指数tophus测量。生活质量（痛风影响评分（GIS））和功能在纳入时和12个月后记录。分别在基线、6月和12月获得足痛风侵蚀评分。比较3个月时达到SU目标的患者和未达到SU目标的患者的结果。结果：患者年龄中位数为47岁，病程中位数为8岁，临床痛风溃疡91例，痛风溃疡70例。6个月时84例，12个月时68例。别嘌呤醇的剂量逐渐增加到中位数600mg /d。注意到M6和M12的照明率以及M12的GIS和功能的显着改善，与SU目标无关。当达到< 300 μmol/l的SU目标时，Tophi（通过照片和US测量来评估）和DC标志从M6显著降低。足部侵蚀评分显著下降，与SU目标无关。7例患者因别嘌呤醇引起轻度皮疹。结论：这项为期一年的开放研究测试了一种全球痛风护理交付模式，在传统草药治疗痛风的越南人群中，治疗尿酸血症的目标是别嘌呤醇，西医自我治疗耀斑，并将患者教育添加到传统草药的背景中。这种转变在实践中导致戏剧性的痛风改善。

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Addition of allopurinol to traditional Vietnamese medicine shows major improvement of 100 gout patients in a single center one-year prospective study

Objectives

Gout is frequently severe in Vietnam, where urate-lowering drugs (ULDs) are seldom used and many patients are treated only with traditional herbal medicine. We assessed the addition of Western medicine on severe gout in Vietnamese people.

Methods

One hundred Vietnamese, ULD-free, crystal-proven gout patients with a GFR > 60 mL/min, were prospectively followed for 1 year after allopurinol initiation. The treatment protocol included allopurinol given according to the 2016 EULAR recommendations, flare prophylaxis with colchicine during the first months, and traditional herbal medicine. At each visit, gout flares were counted by a daily diary, digital foot photographs were taken for semi-quantitative tophus scoring, serum urate (SU) was measured. Ultrasound (US) scan was performed at baseline, 6 and 12 months for double contour (DC) and index tophus measurement. Quality of life (Gout Impact Score [GIS]) and function were recorded at inclusion and after 12 months. Foot gout radiographic erosion scores were obtained at baseline, 6 and 12 months. Outcomes were compared in patients who had reached SU targets at 3 months and those who did not.

Results

Patients’ median age and disease duration were 47 and 8 years respectively, 91 had clinical tophi and 70 foot gouty erosions. Eighty-four patients were seen at 6 months and 68 at 12 months. Allopurinol dosage was progressively increased to a median of 600 mg/d. Significant improvement of flare rates at M6 and M12, and of GIS and function at M12 were noted and did not associate with SU targets. Tophi (assessed by photograph and US measurements) and DC sign significantly decreased from M6 in association with achievement of < 300 μmol/L SU target. Foot erosion scores significantly decreased with no association with SU targets. Mild skin rash to allopurinol developed in 7 patients.

Conclusion

This one-year open study tested a global gout care delivery model in which treat to uricemia target allopurinol, Western medicine self-treatment of flares, and patient education were added to a background of traditional herbal medicine in a Vietnamese population where gout is traditionally treated with herbal medicine. This shift in practice resulted in dramatic gout improvement.

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.