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僵硬关节:降尿酸药物单药治疗与联合治疗急性痛风的比较评估

The Stiff Joint: Comparative Evaluation of Monotherapy and Combination Therapy With Urate Lowering Agents in Managing Acute Gout.

作者信息

Okobi Okelue E, Oletu Helen, Chukwuedozie-Echeazu Adaeze B, Keke Valentine C, Nwachukwu Onyinyechukwu B, Akunne Henrietta S, Ekpemiro Chinwendum U, Oranika Uchechukwu S, Akueme Ngozi T, Akanle Oyewole E, Ogbuagu Buchi C, Mbah Linda A

机构信息

Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA.

Family Medicine, Medficient Health Systems, Laurel, Maryland, USA.

出版信息

Cureus. 2023 Sep 12;15(9):e45087. doi: 10.7759/cureus.45087. eCollection 2023 Sep.

Abstract

Gout, an extremely painful form of arthritis, is triggered by the innate immune system's response to the accumulation of monosodium urate crystals in specific joints and surrounding tissues. This condition is characterized by recurring episodes of excruciating arthritis flares, interspersed with periods of disease quiescence. Over time, gout can result in disability, tophi formation, and severe pain. The treatment of gout is centered around two main objectives: alleviating inflammation and pain during acute gout attacks and long-term management to reduce serum urate levels and mitigate the risk of future attacks. Addressing inflammation and pain during acute attacks is often complicated by various factors, including underlying health conditions commonly associated with gout, such as hypertension, chronic kidney disease, cardiovascular disease, and diabetes mellitus. Moreover, gout patients are frequently older and have multiple coexisting health issues, necessitating complex medication regimens. Given the rising prevalence of gout and its associated comorbidities, there's a growing demand for improved treatment options. While existing treatments effectively manage gout in some patients, a significant portion, particularly those with comorbidities, face contraindications to these treatments and require alternative approaches. Innovative medications are required to enhance gout treatment, especially for individuals with concurrent health conditions. These considerations underscore the importance of reviewing both monotherapy and combination therapy approaches for acute gout treatment.

摘要

痛风是一种极其疼痛的关节炎形式,由先天免疫系统对特定关节及周围组织中尿酸钠晶体的积累作出反应而引发。这种病症的特点是反复发作极度疼痛的关节炎发作期,其间穿插着疾病静止期。随着时间的推移,痛风会导致残疾、痛风石形成和剧痛。痛风的治疗主要围绕两个主要目标:在急性痛风发作期间减轻炎症和疼痛,以及进行长期管理以降低血清尿酸水平并降低未来发作的风险。在急性发作期间解决炎症和疼痛往往因各种因素而变得复杂,这些因素包括通常与痛风相关的潜在健康状况,如高血压、慢性肾病、心血管疾病和糖尿病。此外,痛风患者往往年龄较大且有多种并存的健康问题,需要复杂的药物治疗方案。鉴于痛风及其相关合并症的患病率不断上升,对改进治疗方案的需求也在增加。虽然现有治疗方法能有效治疗部分痛风患者,但很大一部分患者,尤其是那些患有合并症的患者,面临这些治疗的禁忌症,需要替代方法。需要创新药物来加强痛风治疗,特别是对于同时患有其他健康问题的个体。这些考虑凸显了审查急性痛风治疗的单一疗法和联合疗法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4ad/10568651/d39b4e9421a6/cureus-0015-00000045087-i01.jpg

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