title: Combination Therapies of Diacerein and Febuxostat Inhibit IL-1β Responses and Improve Clinical Symptoms in Patients With Refractory Gout.
abstract: There are several therapeutic strategies available for the treatment of an acute gout attack and the prevention of recurrent gout flares, and they include nonsteroid anti-inflammatory drugs. This prospective study was aimed at evaluating the efficiency and safety of diacerein in combination with febuxostat on urate control, global assessments of disease activity, self-monitored gouty acute flare times, inflammatory markers, and clinical symptoms associated with their life quantity in patients with refractory gout. A total of 64 patients with refractory gout were sequentially recruited and prescribed with oral febuxostat alone or febuxostat plus diacerein daily for 12 weeks. The intensity of joint pain, numbers of acute flare, disease activity and the levels of serum amyloid A, mature IL-1β, IL-18, C-reactive protein, and urate in individual subjects were routine analyzed. In comparison with that treatment with febuxostat alone, treatment with both drugs for 12 weeks had a better therapeutic effect on reducing the values of visual analog scales, acute flares, and healthy assessment questionnaire scores in these gout patients. Furthermore, treatment with both drugs also significantly reduced the mean daily dose of etoricoxib and the levels of serum IL-1β and serum amyloid A. There was no significant difference in the frequency of patients with adverse effect between these 2 groups of patients. In conclusion, combination of diacerein and febuxostat had better therapeutic effect on reducing acute gout flares, inflammation, and clinical symptoms in patients with refractory gout.
authors.affiliation: Department of Rheumatology, Wuhan Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yi-Kai
authors.initials: YK
authors.lastname: Yu
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Cong
authors.initials: C
authors.lastname: Ye
authors.forename: Gui-Fen
authors.initials: GF
authors.lastname: Shen
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Lei
authors.forename: Sheng-Tao
authors.initials: ST
authors.lastname: Zhang
authors.forename: Shao-Xian
authors.initials: SX
authors.lastname: Hu
mesh_terms: D000328:Adult; D000880:Anthraquinones / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D000077613:Etoricoxib; D000069465:Febuxostat / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006073:Gout / Q000188:drug therapy* / Q000503:physiopathology; D006074:Gout Suppressants / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D020382:Interleukin-18 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011725:Pyridines / Q000008:administration & dosage; D013450:Sulfones / Q000008:administration & dosage; D016896:Treatment Outcome; D014527:Uric Acid / Q000378:metabolism
chemical_list: D000880:Anthraquinones; D000893:Anti-Inflammatory Agents; D006074:Gout Suppressants; C000589760:IL18 protein, human; D020382:Interleukin-18; D053583:Interleukin-1beta; D011725:Pyridines; D013450:Sulfones; D000069465:Febuxostat; D014527:Uric Acid; C025292:diacerein; D002097:C-Reactive Protein; D000077613:Etoricoxib