PMID- 24186771
OWN - NLM
STAT- MEDLINE
DCOM- 20140520
LR  - 20230223
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
VI  - 2013
IP  - 11
DP  - 2013 Nov 4
TI  - Lifestyle interventions for acute gout.
PG  - CD010519
LID - 10.1002/14651858.CD010519.pub2 [doi]
LID - CD010519
AB  - BACKGROUND: Although lifestyle interventions are often recommended in the 
      management of chronic gout, the evidence from trial data of the benefits and 
      safety of using lifestyle interventions for treating acute gout attacks have not 
      previously been examined in a systematic review. OBJECTIVES: The objective of 
      this systematic review was to evaluate the benefits and safety of lifestyle 
      interventions for the treatment of people with acute gout. SEARCH METHODS: We 
      searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE 
      and EMBASE for studies (up to 5 April 2013). We also searched the 2010 to 2011 
      American College of Rheumatology (ACR) and European League Against Rheumatism 
      (EULAR) abstracts and performed a handsearch of the reference lists of included 
      articles. SELECTION CRITERIA: Studies were included if they were randomised or 
      quasi-randomised controlled trials which compared lifestyle interventions to 
      another therapy (active or placebo) in patients with acute gout. Outcomes of 
      interest were the change in participant-reported pain in the target joint(s), 
      target joint inflammation and function, health-related quality of life (HRQoL), 
      patient global assessment, study participant withdrawals due to adverse events 
      (AEs) and serious adverse events (SAEs). DATA COLLECTION AND ANALYSIS: Two review 
      authors independently applied methods recommended by The Cochrane Collaboration 
      for the selection, appraisal, data collection and synthesis of studies. We 
      assessed the quality of the body of evidence for each outcome using the GRADE 
      approach. MAIN RESULTS: Only one study (19 participants) at high risk of bias was 
      included in the review. Patients were randomised to receive oral prednisolone and 
      colchicine with or without concomitant topical ice therapy. Topical ice therapy 
      provided significant additional benefit over oral prednisolone and colchicine 
      alone with respect to pain, but did not significantly reduce swelling during 
      acute gout episodes. Mean pain reduction with standard medical treatment was 4.4 
      cm on a 0 to 10 cm visual analogue scale (VAS) after one week; the addition of 
      topical ice reduced pain by an additional 3.33 cm (95% CI 5.84 to 0.82), or an 
      absolute reduction of 33% (8% to 58% reduction). Joint swelling was reduced by a 
      mean of 3.8 cm in the standard medical treatment group; the addition of topical 
      ice therapy did not reduce swelling significantly (mean difference (MD) 2.07 cm, 
      95% CI -1.56 to 5.70). Target joint function, HRQoL, patient global assessment, 
      study participant withdrawals due to AEs and SEAs were not reported in this 
      study. AUTHORS' CONCLUSIONS: There is low quality evidence, from a single trial 
      at high risk of bias, that the addition of topical ice therapy to oral 
      prednisolone and colchicine for oligoarticular attacks of acute gout results in 
      significantly greater pain reduction at one week.
FAU - Moi, John H Y
AU  - Moi JH
AD  - Department of Rheumatology, The Royal Melbourne Hospital, Grattan Street, 
      Parkville, Victoria, Australia, 3050.
FAU - Sriranganathan, Melonie K
AU  - Sriranganathan MK
FAU - Edwards, Christopher J
AU  - Edwards CJ
FAU - Buchbinder, Rachelle
AU  - Buchbinder R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20131104
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Gout Suppressants)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - SML2Y3J35T (Colchicine)
SB  - IM
UOF - doi: 10.1002/14651858.CD010519
MH  - Acute Disease
MH  - Anti-Inflammatory Agents/therapeutic use
MH  - Colchicine/administration & dosage
MH  - Combined Modality Therapy/methods
MH  - Cryotherapy/methods
MH  - Drug Therapy, Combination/methods
MH  - Gout/*therapy
MH  - Gout Suppressants/administration & dosage
MH  - Humans
MH  - *Life Style
MH  - Prednisolone/administration & dosage
MH  - Randomized Controlled Trials as Topic
PMC - PMC9942538
COIS- None known
EDAT- 2013/11/05 06:00
MHDA- 2014/05/21 06:00
PMCR- 2014/11/04
CRDT- 2013/11/05 06:00
PHST- 2013/11/05 06:00 [entrez]
PHST- 2013/11/05 06:00 [pubmed]
PHST- 2014/05/21 06:00 [medline]
PHST- 2014/11/04 00:00 [pmc-release]
AID - CD010519.pub2 [pii]
AID - 10.1002/14651858.CD010519.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2013 Nov 4;2013(11):CD010519. doi: 
      10.1002/14651858.CD010519.pub2.