The drug will be used in combination with approved gout drugs such as xanthine oxidase inhibitor (XOIs).
? Controlling hyperuricemia is the key to long-term treatment of gout. ? Dr. Badrul Chowdhury, Director of Lung, Allergy and Rheumatism Products Department of FDA Center for Drug Evaluation and Research, said in the agency's press release. ? Zurampic provides a new treatment option for millions of gout patients. ?
According to the FDA, gout is an arthritis disease in which excessive uric acid accumulates in the body, causing extreme pain. The disease is usually characterized by redness, swelling, heat, pain and swelling of the big toe.
All tissues contain a substance called purine, which naturally decomposes to produce uric acid. The FDA said that most blood-borne uric acid can be excreted harmlessly through the kidney, but too much uric acid will lead to the formation of uric acid crystals, which will lead to gout.
The FDA explained that Zurampic produced by AstraZeneca Pharmaceutical Company in Wilmington helps uric acid excretion through protein which prevents uric acid from reabsorption in the kidney.
* * * A randomized placebo-controlled study of 1500 patients found that Zurampic was effective when combined with XOI * * *. The FDA said that the follow-up found that the patient's blood uric acid content was low when receiving the drug combination.
Some patients will have some side effects, including headache, flu, gastroesophageal reflux disease (chronic heartburn) and high creatinine blood content. Zurampic carries a black warning of high risk of acute renal failure, especially when the dose of the drug is high and it is not used with XOI.
The US Food and Drug Administration (FDA) approved Zurampic(lesinurad) on Tuesday to reduce high levels of uric acid and hyperuricemia in the blood, which are the main factors leading to gout pain.
The drug will be used in combination with approved gout drugs such as xanthine oxidase inhibitor (XOIs).
? Controlling hyperuricemia is the key to long-term treatment of gout. ? Dr. Badrul Chowdhury, Director of Lung, Allergy and Rheumatism Products Department of FDA Center for Drug Evaluation and Research, said in the agency's press release. ? Zurampic provides a new treatment option for millions of gout patients. ?
According to the FDA, gout is an arthritis disease in which excessive uric acid accumulates in the body, causing extreme pain. The disease is usually characterized by redness, swelling, heat, pain and swelling of the big toe.
All tissues contain a substance called purine, which naturally decomposes to produce uric acid. The FDA said that most blood-borne uric acid can be excreted harmlessly through the kidney, but too much uric acid will lead to the formation of uric acid crystals, which will lead to gout.
The FDA explained that Zurampic produced by AstraZeneca Pharmaceutical Company in Wilmington helps uric acid excretion through protein which prevents uric acid from reabsorption in the kidney.
* * * A randomized placebo-controlled study of 1500 patients found that Zurampic was effective when combined with XOI * * *. The FDA said that the follow-up found that the patient's blood uric acid content was low when receiving the drug combination.
Some patients will have some side effects, including headache, flu, gastroesophageal reflux disease (chronic heartburn) and high creatinine blood content. Zurampic carries a black warning of high risk of acute renal failure, especially when the dose of the drug is high and it is not used with XOI.
Common treatment methods of gout
needle therapy
In addition to Chinese medicine treatment, Chinese acupuncture treatment is also very helpful for the rehabilitation of gout patients. Acupuncture of traditional Chinese medicine has a long history in China, and the clinical statistical report points out that the effective rate of acupuncture in treating gout is over 92.3%.
food therapy
Control the intake of high-purine food and eat less food such as animal viscera, seafood and preserved eggs. It contains high purine, which induces the increase of uric acid crystals and leads to recurrent gout. Patients are advised to eat more alkaline foods: steamed bread, bread, noodles, etc. It is beneficial to gastrointestinal digestion, easy to excrete renal function and reduce the formation of tophi.
physiotherapy
The main function of physical therapy is to dredge meridians, promote blood circulation and remove blood stasis, dispel wind and remove dampness, remove blood stasis and dissipate stagnation. This is one of the commonly used methods to treat gout.
Chinese traditional treatment
Combined with traditional Chinese medicine to stabilize uric acid and inhibit uric acid to prevent recurrence in the future. Some gout patients are taking it to suppress uric acid. This medicine itself has dual functions of reducing uric acid and protecting kidney. Chinese medicine is mild, but it can make use of the recovery of the body. This is a common method to treat gout.
The manifestation of gout
1. Acute gouty arthritis
Most patients have no obvious symptoms before onset, or only fatigue, general discomfort and joint tingling. Typical attacks are often awakened by joint pain in the middle of the night, and the pain gradually intensifies, reaching a peak in about 12 hours, showing tearing, cutting or biting, and the pain is unbearable. The affected joints and surrounding tissues are red, swollen, fever, pain and limited in function. Relieve itself in more than a few days or two weeks. The first attack mostly involved a single joint, and some occurred in the first metatarsophalangeal joint. In the later course of the disease, some patients are involved in this part. Followed by instep, heel, ankle joint, knee joint, wrist joint and elbow joint, shoulder, hip, spine and temporomandibular joint are less involved, and multiple joints can be involved at the same time, showing polyarthritis. Some patients may have fever, chills, headache, palpitation, nausea and other systemic symptoms, which may be accompanied by an increase in white blood cell count, erythrocyte sedimentation rate and C-reactive protein.
2. Intermittent attacks
Gout attacks can be relieved by themselves after several days to weeks. Generally, there is no obvious sequelae, or local skin pigmentation, desquamation and itching are left behind. Then it enters the asymptomatic interval and recurs after several months, years or more than ten years. Most patients relapsed within 65,438+0 years, with more and more times, more and more joints involved and longer symptoms. The affected joints generally develop from lower limbs to upper limbs, from distal small joints to large joints, and fingers, wrists, elbows and other joints are involved. A few patients may involve shoulder, hip, sacroiliac joint, sternoclavicular joint or spinal joint, or synovial sac, tendon and tendon sheath around the joint, and the symptoms tend to be atypical. A few patients have no intermission, and they show chronic arthritis after the first onset.
3. Chronic tophus lesion stage
Subcutaneous tophus and chronic tophus arthritis are the results of long-term hyperuricemia, and a large number of monosodium urate crystals are deposited under the skin, synovium, cartilage, bone and soft tissue around the joints. The typical part of subcutaneous tophi is auricle, and it is also common around recurrent joints and parts such as olecranon, achilles tendon and patellar bursa. The appearance is yellowish-white vegetation with different sizes under the skin, and the skin surface is thin. After rupture, white powder or paste is discharged, which will not heal for a long time. Subcutaneous tophi often coexists with chronic tophi arthritis. A large number of tophi deposited in joints can cause joint bone destruction, tissue fibrosis around joints and secondary degenerative changes. The clinical manifestations are persistent joint swelling and pain, tenderness, deformity and dysfunction. Chronic symptoms are relatively mild, but acute attacks may also occur.
4. Kidney disease
(1) Chronic urate nephropathy urate crystals are deposited in renal interstitium, leading to chronic tubulointerstitial nephritis. The clinical manifestations are decreased urine concentration function, increased nocturia, low specific gravity urine, small molecular proteinuria, leukocytosis, mild hematuria and tubular urine. In the late stage, glomerular filtration function may decrease and renal insufficiency may occur.
(2) Uric acid urinary calculi The uric acid concentration in urine is supersaturated and deposited in the urinary system to form stones. The incidence rate in gout patients is above 20%, which may appear before gouty arthritis. Those with smaller stones are gravel-like, which can be excreted with urine without symptoms; Larger cases can block the urinary tract, causing renal colic, hematuria, dysuria, urinary tract infection, renal pelvis dilatation and hydronephrosis.