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Общие принципы и основные рекомендации по ведению и лечению пациентов с подагрой по материалам обновленных европейских рекомендаций
Цурко В.В., Громова М.А. Общие принципы и основные рекомендации по ведению и лечению пациентов с подагрой по материалам обновленных европейских рекомендаций. Consilium Medicum. 2017; 19 (12): 20–24. DOI: 10.26442/2075-1753_19.12.20-24
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Tsurko V.V., Gromova M.A. General principles and guidelines for the management and treatment of patients with gout on the basis of updated European recommendations. Consilium Medicum. 2017; 19 (12): 20–24. DOI: 10.26442/2075-1753_19.12.20-24
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Аннотация
В 2016 г. опубликованы обновленные европейские общие принципы и основные рекомендации по ведению пациентов с подагрой. Акцент делается на фармакологические/нефармакологические методы лечения и на уратснижающую терапию у пациентов с нарушением функции почек. Впервые в России наряду с аллопуринолом рекомендуется препарат с уратснижающим эффектом – фебуксостат. Цель данного обзора – донести до врачей возможность обязательного достижения целевого уровня мочевой кислоты при лечении подагры с гиперурикемией.
Ключевые слова: подагра, гиперурикемия, рекомендации, лечение, фебуксостат.
Ключевые слова: подагра, гиперурикемия, рекомендации, лечение, фебуксостат.
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In 2016, updated European general principles and guidelines for managing patients with gout are published. The emphasis is on pharmacological/non-pharmacological methods of treatment and on urasnizhayuschee therapy in patients with impaired renal function. For the first time in Russia, along with allopurinol, a drug with a uracminating effect is recommended – febuxostat. The purpose of this review is to inform doctors about the mandatory achievement of a target uric acid level in the treatment of gout with hyperuricemia.
Key words: gout, hyperuricemia, recommendations, treatment, febuxostat.
Полный текст
Список литературы
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24. Weisskopf MG, O’Reilly E, Chen H et al. Plasma urate and risk of Parkinson’s disease. Am J Epidemiol 2007; 166: 561–7.
25. Kim TS, Pae CU, Yoon SJ et al. Decreased plasma antioxidants in patients with Alzheimer’s disease. Int J Geriatric Psychiatry 2006; 21: 344–8.
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29. Bardin T, Chales G, Pascart T et al. Risk of cutaneous adverse events with febuxostat treatment in patients with skin reaction to allopurinol. A retrospective, hospital-based study of 101 patients with consecutive allopurinol and febuxostat treatment. Joint Bone Spine 2016; 83: 314–7.
30. Kydd AS, Seth R, Buchbinder R et al. Uricosuric medications for chronic gout. Cochrane Database Syst Rev 2014; 11: CD010457.
31. Hira D, Chisaki Y, Noda S et al. Population pharmacokinetics and therapeutic efficacy of febuxostat in patients with severe renal impairment. Pharmacology 2015; 96: 90–8.
32. Schumacher HR Jr, Becker MA, Wortmann RL et al. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum 2008; 59: 1540–8.
33. Becker MA, Schumacher HRJr, Wortmann RL et al. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005; 353: 2450–61.
34. Becker MA, Schumacher HR, Espinoza LR et al. The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial. Arthritis Res Ther 2010; 12: R63.
35. Abeles AM. Febuxostat hypersensitivity. J Rheumatol 2012; 39: 659.
36. Chohan S. Safety and efficacy of febuxostat treatment in subjects with gout and severe allopurinol adverse reactions. J Rheumatol 2011; 38: 1957–9.
37. Givertz MM, Anstrom KJ, Redfield MM et al. Effects of xanthine oxidase inhibition in hyperuricemic heart failure patients: the xanthine oxidase inhibition for hyperuricemic heart failure patients (EXACT-HF) study. Circulation 2015; 131: 1763–71.
38. Choi HK, Soriano LC, Zhang Y et al. Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study. BMJ 2012; 344: d8190.
39. Derosa G, Maffioli P, Sahebkar A. Plasma uric acid concentrations are reduced by fen of ibrate: a systematic review and meta-analysis of randomized placebo controlled trials. Pharmacol Res 2015; 102: 63–70.
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2. Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры – научно обоснованное требование улучшения трудового и жизненного прогноза больных. Научно-практическая ревматология. 2004; 1: 5–7. / Nasonova V.A., Barskova V.G. Rannie diagnostika i lechenie podagry – nauchno obosnovannoe trebovanie uluchsheniia trudovogo i zhiznennogo prognoza bol'nykh. Nauchno-prakticheskaia revmatologiia. 2004; 1: 5–7. [in Russian]
3. Geiderman JM. An elderly woman with a warm, painful finger. West J Med 2000; 172 (1): 51–2.
4. Richette P, Doherty M, Pascual E et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 2016; Jul 25. PII: annrheumdis-2016-209707. DOI: 10.1136/annrheumdis-2016-209707
5. Simkin PA, Campbell PM, Larson EB. Brief report: Gout in Heberden’s nodes. Arthr Rheum 1983; 26: 97–104. DOI: 10.1016/j.berh.2015.04.024
6. Rees F, Jenkins W, Doherty M. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis 2013; 72: 826–30.
7. Choi JW, Ford ES, Gao X et al. Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2008; 59: 109–16.
8. Zhang Y, Neogi T, Chen C et al. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum 2012; 64: 4004–11.
9. Dalbeth N, Ames R, Gamble GD et al. Effects of skim milk powder enriched with glycomacropeptide and G600 milk fat extract on frequency of gout flares: a proof-of-concept randomised controlled trial. Ann Rheum Dis 2012; 71: 929–34.
10. Chen JH, Wen CP, Wu SB et al. Attenuating the mortality risk of high serum uric acid: the role of physical activity underused. Ann Rheum Dis 2015; 74: 2034–42.
11. Terkeltaub RA, Furst DE, Bennett K et al. High versus low dosing of oral colchicine for early acute gout flare: twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum 2010; 62: 1060–8.
12. Wason S, Mount D, Faulkner R. Single-dose, open-label study of the differences in pharmacokinetics of colchicine in subjects with renal impairment, including end-stage renal disease. Clin Drug Investig 2014; 34: 845–55.
13. Terkeltaub RA, Furst DE, Digiacinto JL et al. Novel evidence-based colchicine dose-reduction algorithm to predict and prevent colchicine toxicity in the presence of cytochrome P450 3A4/P-glycoprotein inhibitors. Arthritis Rheum 2011; 63: 2226–37.
14. Van Durme CM, Wechalekar MD, Buchbinder R et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev 2014; 9: CD010120.
15. Rainer TH, Cheng CH, Janssens HJ et al. Oral prednisolone in the treatment of acute gout: a pragmatic, multicenter, double-blind, randomized trial. Ann Intern Med 2016; 164: 464–71.
16. Janssens HJ, Janssen M, van de Lisdonk EH et al. Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomized equivalence trial. Lancet 2008; 371: 1854–60.
17. Wechalekar MD, Vinik O, Schlesinger N et al. Intra-articularglucocorticoids for acute gout. Cochrane Database Syst Rev 2013; 4: CD009920.
18. Schlesinger N, Alten RE, Bardin T et al. Canakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensions. Ann Rheum Dis 2012; 71: 1839–48.
19. Ghosh P, Cho M, Rawat G et al. Treatment of acute gouty arthritis in complex hospitalized patients with anakinra. Arthritis Care Res (Hoboken) 2013; 65: 1381–4.
20. Finkelstein Y, Aks SE, Hutson JR et al. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila) 2010; 48: 407–14.
21. Becker MA, MacDonald PA, Hunt BJ et al. Determinants of the clinical outcomes of gout during the first year of urate-lowering therapy. Nucleosides Nucleotides. Nucleic Acids 2008; 27: 585–91.
22. Wortmann RL, Macdonald PA, Hunt B et al. Effect of prophylaxis on gout flares after the initiation of urate-lowering therapy: analysis of data from three phase III trials. Clin Ther 2010; 32: 2386–97.
23. Halevy S, Ghislain PD, Mockenhaupt M et al. Allopurinol is the most common cause of Stevens-Johnson syndrome and toxic epidermal necrolysis in Europe and Israel. J Am Acad Dermatol 2008; 58: 25–32.
24. Weisskopf MG, O’Reilly E, Chen H et al. Plasma urate and risk of Parkinson’s disease. Am J Epidemiol 2007; 166: 561–7.
25. Kim TS, Pae CU, Yoon SJ et al. Decreased plasma antioxidants in patients with Alzheimer’s disease. Int J Geriatric Psychiatry 2006; 21: 344–8.
26. Abraham A, Drory VE. Influence of serum uric acid levels on prognosis and survival in amyotrophic lateral sclerosis: a meta-analysis. J Neurol 2014; 261: 1133–8.
27. Bardin T. Hyperuricemia starts at 360 micromoles (6 mg/dL). Joint Bone Spine 2015; 82: 141–3.
28. Noman A, Ang DS, Ogston S et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Lancet 2010; 375: 2161–7.
29. Bardin T, Chales G, Pascart T et al. Risk of cutaneous adverse events with febuxostat treatment in patients with skin reaction to allopurinol. A retrospective, hospital-based study of 101 patients with consecutive allopurinol and febuxostat treatment. Joint Bone Spine 2016; 83: 314–7.
30. Kydd AS, Seth R, Buchbinder R et al. Uricosuric medications for chronic gout. Cochrane Database Syst Rev 2014; 11: CD010457.
31. Hira D, Chisaki Y, Noda S et al. Population pharmacokinetics and therapeutic efficacy of febuxostat in patients with severe renal impairment. Pharmacology 2015; 96: 90–8.
32. Schumacher HR Jr, Becker MA, Wortmann RL et al. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum 2008; 59: 1540–8.
33. Becker MA, Schumacher HRJr, Wortmann RL et al. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005; 353: 2450–61.
34. Becker MA, Schumacher HR, Espinoza LR et al. The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial. Arthritis Res Ther 2010; 12: R63.
35. Abeles AM. Febuxostat hypersensitivity. J Rheumatol 2012; 39: 659.
36. Chohan S. Safety and efficacy of febuxostat treatment in subjects with gout and severe allopurinol adverse reactions. J Rheumatol 2011; 38: 1957–9.
37. Givertz MM, Anstrom KJ, Redfield MM et al. Effects of xanthine oxidase inhibition in hyperuricemic heart failure patients: the xanthine oxidase inhibition for hyperuricemic heart failure patients (EXACT-HF) study. Circulation 2015; 131: 1763–71.
38. Choi HK, Soriano LC, Zhang Y et al. Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study. BMJ 2012; 344: d8190.
39. Derosa G, Maffioli P, Sahebkar A. Plasma uric acid concentrations are reduced by fen of ibrate: a systematic review and meta-analysis of randomized placebo controlled trials. Pharmacol Res 2015; 102: 63–70.
40. Takagi H, Umemoto T. Atorvastatin therapy reduces serum uric acid levels: a meta-analysis of randomized controlled trials. Int J Cardiol 2012; 157: 255–7.
41. Rothenbacher D, Primatesta P, Ferreira A et al. Frequency and risk factors of gout flares in a large population-based cohort of incident gout. Rheumatology (Oxford) 2011; 50: 973–81.
42. Dalbeth N, Chen P, White M et al. Impact of bariatric surgery on serum urate targets in people with morbid obesity and diabetes: a prospective longitudinal study. Ann Rheum Dis 2014; 73: 797–802.
43. Yamanaka H. Gout and hyperuricemia in young people. Curr Opin Rheumatol 2011; 23: 156–60.
44. Luk AJ, Simkin PA. Epidemiology of Hyperuricemia and Gout. Am J Manag Care 2005; 11: 435–42.
45. Roddy E, Choi HK. Epidemiology of gout. Rheum Dis Clin North Am 2014; 40: 155–75.
46. Атаханова Л.Э., Цурко В.В., Булеева И.М. и др. Подагра: от этиологии и патогенеза к диагностике и рациональной терапии. Современная ревматология. 2007; 1: 13–8. / Atakhanova L.E., Tsurko V.V., Buleeva I.M. i dr. Podagra: ot etiologii i patogeneza k diagnostike i ratsional'noi terapii. Sovremennaia revmatologiia. 2007; 1: 13–8. [in Russian]
47. Kuo CF, Grainge MJ, Mallen C et al. Eligibility for and prescription of urate-lowering treatmentinpat in patients with incident gout in England. JAMA 2015; 312: 2684–6.
48. Цурко В.В., Елисеева М.Е., Воробьев П.А. Особенности течения подагры в пожилом возрасте. Терапевт. арх. 2014; 5 (86): 50–5. / Tsurko V.V., Eliseeva M.E., Vorob'ev P.A. Osobennosti techeniia podagry v pozhilom vozraste. Terapevt. arkh. 2014; 5 (86): 50–5. [in Russian]
49. Воробьев П.А., Цурко В.В., Елисеева М.Е. Подагра в гериатрической практике. Методические рекомендации. Часть I. Клин. геронтология. 2016; 3–4 (22): 3–9. / Vorob'ev P.A., Tsurko V.V., Eliseeva M.E. Podagra v geriatricheskoi praktike. Metodicheskie rekomendatsii. Chast' I. Klin. gerontologiia. 2016; 3–4 (22): 3–9. [in Russian]
50. Liu SC, Xia L, Zhang J et al. Gout and risk of myocardial infarction: a systematic review and meta-analysis of cohort studies. PLoS ONE 2015; 10: e0134088.
51. Clarson LE, Hider SL, Belcher J et al. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Ann Rheum Dis 2015; 74: 642–7.
52. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation 2007; 116: 894–900.
53. Juraschek SP, Kovell LC, Miller ER et al. Association of kidney disease with prevalent gout in the United States in 1988–1994 and 2007–2010. Semin Arthritis Rheum 2013; 42 (6): 551–61.
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Авторы
В.В.Цурко1,2, М.А.Громова*2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 1;
2 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*margarita-gromov@mail.ru
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 1;
2 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*margarita-gromov@mail.ru
________________________________________________
V.V.Tsurko1,2, M.A.Gromova*2
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
2 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovityanova, d. 1
*margarita-gromov@mail.ru
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