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Ann Intern Med:泼尼松龙——急性痛风的一线治疗药物

2016-02-25 MedSci MedSci原创

Ann Intern Med:泼尼松龙——急性痛风的一线治疗药物最近的两项双盲随机对照试验(RCTs)表明,痛风治疗时口服类固醇和非甾体类抗炎药的镇痛效果相似,但是这两项试验的样本量较小,同时还存在一些方法学上的局限性。本研究旨在对比急诊科(EDs)急性痛风患者口服泼尼松龙与口服吲哚美辛治疗的安全性和有效性。设计一项多中心,双盲,随机等效性试验。共纳入了416名18岁及以上的患者(来自香港的4家E

最近的两项双盲随机对照试验(RCTs)表明,痛风治疗时口服类固醇和非甾体类抗炎药的镇痛效果相似,但是这两项试验的样本量较小,同时还存在一些方法学上的局限性。

本研究旨在对比急诊科(EDs)急性痛风患者口服泼尼松龙与口服吲哚美辛治疗的安全性和有效性。

设计一项多中心,双盲,随机等效性试验。共纳入了416名18岁及以上的患者(来自香港的4家EDs),随机分配(1:1)至吲哚美辛治疗组和泼尼松龙治疗组。

定义镇痛的有效性为100 mm的视觉模拟量表中疼痛的变化(在休息或活动)大于13mm。在患者就诊于ED后2小时及就诊后第1-14天测量镇痛的结果。

最终376名患者完成了这项研究。两组患者的平均疼痛评分降低程度相当,且都具有临床意义(约10 mm[休息]和20 mm[活动]),从第1天到第14天(约25 mm[休息]和45 mm [活动])。研究期间并未发生重大不良事件。ED内治疗期间,吲哚美辛治疗组患者较泼尼松龙治疗组患者出现较多的轻微不良反应事件(19% VS. 6%;P<0.001)。治疗第1天至第14天,每组患者均有37%的患者出现轻微的不良反应事件。

总而言之,口服类固醇和吲哚美辛对于急性痛风患者的镇痛效果相似。泼尼松龙是治疗急性痛风的一种安全且有效的一线治疗药物。

原始出处:

Timothy Hudson Rainer, Chi Hung Cheng, et al., Oral Prednisolone in the Treatment of Acute Gout: A Pragmatic, Multicenter, Double-Blind, Randomized Trial. Ann Intern Med. Published online 23 February 2016 doi:10.7326/M14-2070


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    2016-09-29 1decafd9m46(暂无匿称)

    老年男性下肢脚趾痛风发作合并脑梗的如何治疗

    0

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    2016-02-26 卡莲

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