Вплив низьких доз колхіцину на клінічний перебіг і функцію нирок у хворих на подагру на тлі метаболічного синдрому

Abstract

Исследование посвящено оценке эффективности длительного применения низких доз колхицина в дополнение к стандартной терапии у пациентов с подагрой на фоне метаболического синдрома и его влиянию на клиническое течение основного заболевания и на функцию почек. Результаты исследования свидетельствуют о том, что предложенная схема лечения эффективно снижает количество приступов подагрического артрита, активность воспалительного процесса, что проявляется в уменьшении количества воспаленных суставов, улучшении биохимических маркеров воспаления и маркеров почечной функции.

Patients with gout and metabolic syndrome (MS) require more attention, because this combination has a negative impact not only on the musculoskeletal system, but also on the functional state of the kidneys. Finding the optimal treatment regimen for such patients is an actual question. Objective: to investigate the effect of low doses of colchicine on the clinical course and renal function in patients with gout and MS. Materials and methods: 65 men with primary gout and MS were examined. The average age of patients was 50.4±7.6, the average duration of gout was (8.0±2.1) years. Patients were divided into 2 groups: the first group was prescribed low doses of colchicine (0.5 mg per day) in combination with allopurinol (200 mg per day with titration of dose as needed) for 6 months, with a repeat course 4 months later. In the second group, only allopurinol (200 mg per day with titration of dose as needed) was prescribed. Results and discussion: After 12 and 24 months the difference in the number of affected joints was significantly lower in the main group. There was also a more pronounced tendency to reduce the number of attacks of gouty arthritis in the main group. In the study of markers of inflammation after 12 and 24 months, there was a statistically significant decrease in CRP and seromucoids in the main group, while fibrinogen and ESR tended to decrease, but the difference was not statistically significant. The decrease in uric acid concentration was in both groups, more significant in the main group. The concentration of creatinine, urea and glomerular filtration rate significantly improved in the main group. So, adding low doses of colchicine for a long course (according to the scheme) in addition to standard therapy can be recommended in order to reduce visceral and clinical manifestations of systemic gouty inflammation against the background of MS.