At the Western Conference on Clinical Rheumatology to be held from September 18 to 21, 2021, Professor Kenneth G.
Saag of the University of Alabama at Birmingham, after reviewing the current research and clinical data, told the participants: For gout patients with chronic kidney disease (CKD), they are not adequately treated
"For patients with acute attacks of gout, the traditional view is that glucocorticoids such as prednisone are not helpful to these patients, but Kenneth Professor G.
Saag pointed out that “large doses of glucocorticoids can help patients relieve pain and inflammation
” In the acute phase of gout, 30 to 35 mg of prednisone per day can control the onset of gout, and the effect is similar to that of non-steroidal anti-inflammatory drugs.
In addition, for patients with contraindications to non-steroidal anti-inflammatory drugs, including CKD, heart failure or hypertension, the use of glucocorticoids is a good intervention
Although long-term use of glucocorticoids can cause many complications, short-term use does not have too many adverse events
On the other hand, some traditional management believes that for patients with acute gout, taking 1.
8 mg of colchicine every 1 hour is worse than taking 4.
8 mg of colchicine every 6 hours or more
In addition, diarrhea is considered an inevitable adverse reaction of colchicine
However, the results of the AGREE trial showed that although diarrhea is still an inevitable adverse reaction, there is no significant difference between low-dose and high-dose colchicine in controlling acute attacks of gout
However, for some patients with muscle diseases and CKD, the dosage of colchicine requires high attention
This is very important for gout patients with CKD
In addition, Professor Kenneth G.
Saag found that the interleukin-1 inhibitor, Canakinumab, is superior to triamcinolone acetonide in terms of efficacy
However, it has some safety issues, resulting in it has not been approved by the U.
Food and Drug Administration (FDA).
However, another interleukin-1 inhibitor, Anakirna’s research report shows that its safety is better, or it may become part of the problem.
Good news for patients who use non-steroidal anti-inflammatory drugs and hormone drugs
Improving management of gout flares may require defying'conventionalwisdom'.