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首页> 美国卫生研究院文献>Springer Open Choice >Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review
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Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review

机译：系统性文献综述在急性痛风发作期间开始降低尿酸盐治疗是否会延长当前发作并加剧复发发作：系统的文献综述

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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.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3579-z) contains supplementary material, which is available to authorized users.
机译：本研究的目的是系统地复习有关痛风急性发作期间尿酸降低治疗（ULT）对指数发作持续时间和ULT持续性影响的文献。搜索OVID（Medline），EMBASE和AMED，以鉴定以英语发布的急性痛风发作期间ULT引发的随机对照试验（RCT）。两名评论者评估研究质量并独立提取数据。标准化的均值差异（SMD）和相对风险（RR）用于汇总连续数据和分类数据。使用STATA 14版进行荟萃分析。总共选择了537项研究。移除重复项后，总共对487个标题和摘要进行了审查。确定了三个RCT。两项高质量的研究表明，在10-15天早期开始别嘌呤醇并不会增加疼痛的严重程度[SMDpooled（95％CI）0.18（-0.58，0.93）]。来自三项研究的数据表明，在痛风急性发作期间ULT的发作与辍学无关[RRpooled（95％CI）1.16（0.58，2.31）]。有中等质量的证据表明，在痛风急性发作期间开始ULT并不会增加疼痛的严重程度和ULT停药的风险。需要进行更大的研究才能证实这些发现，以便可以对ULT引起的急性痛风患者信心十足。电子补充材料本文的在线版本（doi：10.1007 / s00296-016-3579-z）包含补充材料，可以通过以下途径获得给授权用户。

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