痛风

• What are the benefits and harms of colchicine in people with acute gout?
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• In people with chronic gout, is there randomized controlled trial evidence to support the use of lifestyle interventions?
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• Does febuxostat improve outcomes in people with chronic gout?
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证据评分

证据 A 聚乙二醇重组尿酸酶治疗难治性痛风的效力：高质量的证据显示，对于使用别嘌呤醇和非布司他难以治疗的患者，静脉注射聚乙二醇重组尿酸酶可能降低血清尿酸水平。[73]Sundy JS, Baraf HS, Yood RA, et al. Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials. JAMA. 2011;306:711-720.http://jama.jamanetwork.com/article.aspx?articleid=1104232http://www.ncbi.nlm.nih.gov/pubmed/21846852?tool=bestpractice.com[74]Baraf H, Gutierrez-Urena SR, Vazquez-Mellado J, et al. Progressive reduction in tophus burden with pegloticase therapy in patients with chronic gout refractory to conventional therapy. Arthritis Rheum. 2010;62(suppl):157.http://www.blackwellpublishing.com/acrmeeting/abstract.asp?MeetingID=774&id=88812 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

聚乙二醇重组尿酸酶治疗难治性痛风的效力：高质量的证据显示，对于使用别嘌呤醇和非布司他难以治疗的患者，静脉注射聚乙二醇重组尿酸酶可能降低血清尿酸水平。[73]Sundy JS, Baraf HS, Yood RA, et al. Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials. JAMA. 2011;306:711-720.http://jama.jamanetwork.com/article.aspx?articleid=1104232http://www.ncbi.nlm.nih.gov/pubmed/21846852?tool=bestpractice.com[74]Baraf H, Gutierrez-Urena SR, Vazquez-Mellado J, et al. Progressive reduction in tophus burden with pegloticase therapy in patients with chronic gout refractory to conventional therapy. Arthritis Rheum. 2010;62(suppl):157.http://www.blackwellpublishing.com/acrmeeting/abstract.asp?MeetingID=774&id=88812

证据 B 症状减轻：有中等质量证据显示，在减轻急性痛风患者的症状方面，皮质类固醇和非甾体抗炎药 (NSAID) 一样有疗效。 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

症状减轻：有中等质量证据显示，在减轻急性痛风患者的症状方面，皮质类固醇和非甾体抗炎药 (NSAID) 一样有疗效。

证据 C 疼痛减轻：质量差的证据显示，在减轻痛风患者的疼痛方面，没有一种非甾体抗炎药比其他药物更有效。[53]Terkeltaub R, Furst RE, Bennett K, et al. Colchicine efficacy assessed by time to 50% reduction of pain is comparable in low dose and high dose regimens: secondary analyses of the AGREE trial. Abstract presented at: American College of Rheumatology Scientific Meeting; October 2009; Philadelphia, PA. 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

疼痛减轻：质量差的证据显示，在减轻痛风患者的疼痛方面，没有一种非甾体抗炎药比其他药物更有效。[53]Terkeltaub R, Furst RE, Bennett K, et al. Colchicine efficacy assessed by time to 50% reduction of pain is comparable in low dose and high dose regimens: secondary analyses of the AGREE trial. Abstract presented at: American College of Rheumatology Scientific Meeting; October 2009; Philadelphia, PA.