Immediate Prescription of a Hypouricemic Treatment, Febuxostat, Compared to Its Delayed Administration
Status:
Not yet recruiting
Trial end date:
2025-08-01
Target enrollment:
Participant gender:
Summary
Gout, the most common inflammatory rheumatism in France, is a complication of chronic
hyperuricemia (> 360umol / l). The resulting urate crystals are deposited in many tissues,
especially the skeletal or kidneys. It appears in the form of spontaneously regressive
inflammatory joint attacks in 5 to 7 days but recurrent. Gout turns into a chronic disease if
uric acidemia is not reduced, and is responsible for joint destruction. It becomes a vector
of renal failure and is associated with cardiovascular morbidity and a reduction in life
expectancy. It is cured if a long-term treatment such as febuxostat leading to the
normalization of the uric acidemia is administered.
However, the frequency of this disease is increasing in industrialized or emerging countries.
The causes are numerous, particularly food, but also related to flaws in therapeutic care.
Studies show that this treatment is not taken in particular because, after the acute attack,
the patient who has become asymptomatic again no longer consults. Currently, in a traditional
way and according to European recommendations, it is not prescribed until several weeks after
the acute attack in order to avoid early relapses, which would then be more numerous.
Nevertheless, even if the hypouricemic agent is prescribed late , the attacks can be repeated
and become rare for several months after obtaining a uricemia below 360umol / l; they
eventually disappear. Lack of knowledge of this disease largely affects the hazards of
disease-modifying treatment, which alone can prevent the progression to chronic inflammatory
disease and its cardiovascular and renal impact and on mortality. One of the causes of not
taking a hypouricemic agent is its delayed administration.
This study is proposed to assess the relevance of early initiation versus delayed
administration of such treatment.