■痛风性关节炎(GA)是由尿酸单钠(MSU)晶体沉积引起的晶体相关关节疾病,与嘌呤代谢紊乱和/或尿酸排泄减少导致的高尿酸血症直接相关。典型痛风性关节炎的急性发作通常通过临床使用NSAIDs缓解,秋水仙碱,或者糖皮质激素。然而,管理慢性难治性痛风患者面临挑战,由于并发症,如多个痛风石,痛风性肾病,糖尿病,和消化道出血.虽然近年来有许多关于痛风的研究,关于慢性难治性痛风的研究仍然有限。此类案件的管理仍面临几个悬而未决的问题,包括疾病复发和患者依从性差,导致药物利用不足和副作用风险增加。在这份报告中,我们介绍了一例使用生物制剂upadacitinib缓释片成功改善慢性难治性痛风性关节炎的病例.
我们的病例报告涉及一名53岁的亚洲复发性痛风性关节炎患者,其病史超过20年,没有接受常规治疗,呈现托比和越来越多的痛苦发作。住院期间,各种镇痛药和消炎药提供的救济不足,需要使用类固醇来缓解症状。然而,逐渐减少类固醇被证明具有挑战性。我们决定在治疗方案中加入upadacitinib缓释片,最终改善了病人的病情。经过6个月的随访,患者没有经历任何进一步的急性疼痛发作。
■该病例强调了upadacitinib缓释片在慢性难治性痛风性关节炎急性期的潜在治疗效果。
UNASSIGNED: Gouty
arthritis (GA) is a crystal-related joint disease caused by the deposition of monosodium urate (MSU) crystals, directly associated with hyperuricemia resulting from purine metabolism disorder and/or reduced uric acid excretion. Acute attacks of typical gouty arthritis are generally relieved through the clinical use of NSAIDs, colchicine, or glucocorticoids. However, managing patients with chronic refractory gout poses challenges due to complications such as multiple tophi, gouty nephropathy, diabetes, and gastrointestinal bleeding. While there have been numerous studies on gout in recent years, research specifically regarding chronic refractory gout remains limited. The management of such cases still faces several unresolved issues, including recurrent disease flare-ups and poor patient compliance leading to inadequate drug utilization and increased risk of side effects. In this report, we present a
case of successful improvement in chronic refractory gouty
arthritis using the biologic agent upadacitinib sustained-release tablets.
UNASSIGNED: Our
case report involves a 53 years-old Asian patient with recurrent gouty
arthritis who had a history of over 20 years without regular treatment, presenting with tophi and an increasing number of painful episodes. During hospitalization, various analgesics and anti-inflammatory drugs provided inadequate relief, requiring the use of steroids to alleviate symptoms. However, tapering off steroids proved challenging. We decided to add upadacitinib sustained-release tablets to the treatment regimen, which ultimately improved the patient\'s condition. After 6 months of follow-up, the patient has not experienced any further acute pain episodes.
UNASSIGNED: This
case highlights the potential therapeutic effect of upadacitinib sustained-release tablets during the acute phase of chronic refractory gouty
arthritis.