Effects of febuxostat combined with indomethacin on serum uric acid,pain and oxidative stress in gouty arthritis patients

Pan Aiping; Jin Xiaoping; Jiazireya Zaiyinati

doi:10.3969/j.issn.1671-6450.2024.08.010

Abstract：Objective To investigate the effect of febuxostat combined with indomethacin on serum uric acid,pain and oxidative stress in gouty arthritis patients.Methods A total of 86 patients with gouty arthritis were included in our hospital.They were randomly divided into observation group(n=43)and control group(n=43).Patients in the control group received febuxostat tablets orally,and patients in the observation group received indomethacin tablets orally on this basis.All patients continued treatment for 1 month.Visual analogue scale(VAS)was used to assess the degree of joint pain before treatment,2 weeks and 1 month after treatment.Serum creatinine(SCr),uric acid(UA),urea nitrogen(BUN)and other renal function indexes were compared between the two groups before and after treatment.Serum interleukin 1β(IL-1β),NACHT-LR-PYD-containing protein3(NALP3),tumor necrosis factor-α(TNF-α)and other inflammatory markers;Glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)in serum were related to oxidative stress.Clinical efficacy and adverse event incidence were evaluated.Results The total effectiveness rate of the observation group stood at 88.37％,outshining the control group's rate of 69.77％(x2/P=4.497/0.034).Following a 2-week treatment period,both groups witnessed a decrease in average VAS scores compared to pre-treatment levels(t/P=5 324/＜0.001).Moreover,the observation group displayed lower average serum levels of UA and Scr in comparison to the control group(t/P=3.081/0.003,2.692/0.009).In addition,the observation group exhibited reduced average serum levels of IL-1β and NALP3 post-treatment,surpassing both pre-treatment levels and those of the control group(t/P=5.587/＜0.001,2.465/0.016).Conversely,the average serum levels of GSH-Px and SOD saw an increase compared to pre-treatment levels and exceeded those of the control group.Meanwhile,the average serum MDA levels decreased,falling below the control group's levels(t/P=3.709/＜0.001,3.655/＜0.001,3.653/＜0.001).Additionally,the observation group experienced a shorter average pain disappearance time than the control group(t/P=4.025/＜0.001).Furthermore,the total occurrence of drug-related adverse events was lower in the observation group,albeit the variance was not deemed statistically significant in comparison to the control group(11.63％vs 18.60％,x2/P=0.816/0366).Conclusion Febuxostat combined with indomethacin has more significant effect on renal function improvement in patients with gouty arthritis.Meanwhile,the combination therapy can effectively reduce the inflammatory level and oxidative stress level of patients,which is conducive to improving the clinical efficacy of patients and has good clinical safety.It has certain clinical application value for patients with gouty arthritis.