The effectiveness of complex therapy in patients with gout using carbon enterosorbent

Abstract

Introduction. Gout is a serious medical, social and economic problem today. It becomes even more important due to its comorbidity. The relationship of pathogenetic mechanisms in the development and progression of gout and non-alcoholic fatty liver disease (NAFLD) has been proven. The presence of concomitant pathology enhances the inflammatory reaction in the body and significantly complicates the course of the underlying disease.

The aim of the study – to evaluate the indicators of systemic inflammatory response in patients with gout and gout with NAFLD when included in the complex therapy of the disease carbon enterosorbent carboline.

Materials and Methods. 123 patients with gout in the period of exacerbation were examined, who were divided into two groups. Group I included 65 patients with gout without liver damage, group II – 58 people with concomitant NAFLD. To determine the effectiveness of treatment, both groups were divided into subgroups: IA (27 people) and IIA (23 patients) who received conventional treatment. Subgroups IB (38 patients) and IIB (35 subjects) additionally received enterosorbent carboline. The control group consisted of 30 healthy individuals. A general clinical examination (collection of complaints, history, objective examination), determination of pain intensity on a visual-analog scale (VAS), biochemical (uric acid level (UA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) ) and enzyme-linked immunosorbent assays (tumor necrosis factor-α) (TNF-α), interleukins 1 (IL-1β) and 10 (IL-10) were conducted.

Results. Patients in both groups had typical clinical signs of joint syndrome. In patients with gout an increase in UA, CRP, ESR, imbalance of cytokine regulation (IL-1β, TNF-α, IL-10) was revealed. These changes increased in the presence of concomitant NAFLD. Significant decrease in the concentration of UA, CRP, ESR, cytokine content after treatment was in all subgroups, but more in patients who received carbon enterosorbent with basic therapy.

Conclusions. The inclusion of the carbon enterosorbent carboline in the complex treatment of patients with gout and gout with NAFLD in the acute phase, promotes faster reverse dynamics of the clinical manifestations of the disease, accompanied by a more significant decrease of the level of UA, CRP, ESR and cytokines in blood serum.