Metabolic factors determining the effectiveness of hypouricemic treatment of gouty arthritis


  • O.V. Syniachenko Donetsk National Medical University, Lyman, Ukraine
  • D.M. Fedorov Donetsk National Medical University, Lyman, Ukraine
  • M.V. Yermolaieva Donetsk National Medical University, Lyman, Ukraine
  • V.V. Pylypenko Donetsk National Medical University, Lyman, Ukraine



gout, arthritis, metabolic factors, treatment, efficacy


Background. The treatment of some forms of arti­cular pathology with gout remains insufficiently effective, and often it’s impossible to achieve normal indicators of uricemia on the background of uric acid-normalizing medicines. The purpose of the study is to evaluate the effect of the initial parameters of purine metabolism and molecules of medium mass (MMM) of different fractions on the effectiveness of uricodepressive and uricosuric therapy of gouty arthritis. Materials and methods. One hundred five patients with primary gout were exa­mined: 92 % of men and 8 % of women aged 26 to 76 years. Before the beginning of the treatment, the content of purine metabolism factors (uric acid, oxypurinol, adenine, guanine, xanthine, hypoxanthine, xanthine oxidase, xanthine deaminase, adenosine deaminase, 5-nucleotidase, molybdenum, lead), as well as MMM of different fractions (aminopeptide (AF), peptide (PF), nucleotide (NF), chromatogra­phic (ChF)) and integral medium molecular index (MMI) were studied in the blood serum. A spectrophotometer SF46, Olympus-AU640 bioana­lyzer and an atomic absorption spectro­meter with SolAAr-Mk2-MOZe electrographitic atomi­zer were used. The efficacy of treatment was assessed after 3–5 weeks. Results. In 27 % of cases, a slight improvement was observed, in 68 % — an improvement, in 8 % — a significant improvement. Primary gout occurs with disturbances in the metabolism of uric acid, oxypurinol, purine bases, purine metabolism enzymes and purine-associated microelements. The integral changes of them depend on the type of the joint syndrome, the presence of peri­pheral and bone tophi, determine bone-destructive articular injuries, while the predictive factor for the severity of arthropathy is considered to be the high level of purine bases in the blood. In cases of gout, the concentration of AF, PF, NF, ChF increases, as well as MMI. Meanwhile, the AF content is closely related to the severity of the joint syndrome, it determines the degree of joint space narrowing and subchondral sclerosis, the development of bone erosions and meniscus changes, and the MMM of different fractions correlate with the parameters of purine metabolism. A significant improvement and improvement during the pathogenetic the­rapy is observed in 3/4 of patients that is closely related to the form of arthritis, the presence of tophi and intraarticular Hoffa’s bodies, as well as the type of hyperuricemia, depends on the use of febuxostat, statins and fibrates, the state of purine metabolism, levels of MMM, NF and ChF fractions. Conclusions. The studied metabolic factors are not only involved in the pathogenesis of gouty arthritis, but also have an impact on the efficacy of uric acid-normalizing drugs.


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Bolzetta F, Veronese N, Manzato E, Sergi G. Chronic gout in the elderly. Aging Clin Exp Res. 2013 May;25(2):129-37. doi: 10.1007/s40520-013-0031-z.

Manara M, Bortoluzzi A, Favero M, et al. Italian society of rheumatology recommendations for the management of gout. Reumatismo. 2013;65(1):4-21. doi: 10.1074/jbc.M115.649855.

Hayward RA, Rathod T, Roddy E, Muller S, Hider SL, Mallen CD. The association of gout with socioeconomic status in primary care: a cross-sectional observational study. Rheumatology (Oxford). 2013 Nov;52(11):2004-8. doi: 10.1093/rheumatology/ket262.

Richette P, Garay R. Novel drug discovery strategies for gout. Expert Opin Drug Discov. 2013 Feb;8(2):183-9. doi: 10.1517/17460441.2013.742061.

Singh JA, Cleveland JD. Comparative effectiveness of allopurinol versus febuxostat for preventing incident renal disease in older adults: an analysis of Medicare claims data. Ann Rheum Dis. 2017 Oct;76(10):1669-1678. doi: 10.1136/annrheumdis-2017-211210.

Kiadaliri AA, Uhlig T, Englund M. Burden of gout in the Nordic region, 1990-2015: findings from the Global Burden of Disease Study 2015. Scand J Rheumatol. 2018 Sep;47(5):410-417. doi: 10.1080/03009742.2017.1405461.

Kuo CF, Grainge MJ, See LC, et al. Epidemiology and management of gout in Taiwan: a nationwide population study. Arthritis Res Ther. 2015 Jan 23;17:13. doi: 10.1186/s13075-015-0522-8.

Sivera F, Andres M, Carmona L, et al. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative. Ann Rheum Dis. 2014 Feb;73(2):328-35. doi: 10.1136/annrheumdis-2013-203325.

Crittenden DB, Pillinger MH. The year in gout: 2012-2013 – a walk through the 2012 ACR Gout Treatment Guidelines. Bull Hosp Jt Dis (2013). 2013;71(3):189-93.

Dubreuil M, Neogi T, Chen CA, Choi HK, Chaisson CE, Hunter DJ, Zhang Y. Increased risk of recurrent gout attacks with hospitalization. Am J Med. 2013 Dec;126(12):1138-41.e1. doi: 10.1016/j.amjmed.2013.06.026.

Fang ZH, Waizy H. Current concepts in the treatment of gouty arthritis. Orthop Surg. 2013 Feb;5(1):6-12. doi: 10.1111/os.12024.

Zarowitz BJ, O'Shea TE. Demographic and clinical profile of nursing facility residents with gout. Consult Pharm. 2013 Jun;28(6):370-82. doi: 10.4140/TCP.n.2013.370.



How to Cite

Syniachenko, O., Fedorov, D., Yermolaieva, M., & Pylypenko, V. (2021). Metabolic factors determining the effectiveness of hypouricemic treatment of gouty arthritis. PAIN, JOINTS, SPINE, 8(3), 124–128.



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