RT Journal Article
SR Electronic
T1 Lifestyle Interventions for the Treatment of Gout: A Summary of 2 Cochrane Systematic Reviews
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 26
OP 32
DO 10.3899/jrheum.140459
VO 92
A1 John H.Y. Moi
A1 Melonie K. Sriranganathan
A1 Louise Falzon
A1 Christopher J. Edwards
A1 Désirée M. van der Heijde
A1 Rachelle Buchbinder
YR 2014
UL http://www.jrheum.org/content/92/26.abstract
AB Objective. To determine the efficacy and safety of lifestyle interventions for treating gout. Methods. Two Cochrane systematic reviews assessed the efficacy and safety of lifestyle interventions for the treatment of acute and chronic gout. We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to September 2011, and the 2010–2011 American College of Rheumatology and European League Against Rheumatism conference abstracts. Primary outcomes of interest were joint pain for acute gout, frequency of gout attacks for chronic gout, and withdrawals due to adverse events for both reviews. Results. One trial met inclusion criteria for each review. An unblinded trial (19 participants), at high risk of bias, found that topical ice added to prednisolone and colchicine for acute gout resulted in significantly greater pain reduction at 1 week [mean difference (MD) −3.33 cm, 95% confidence interval (95% CI) −5.84 to −0.82 on 10 cm visual analog scale]. Adverse events were not described. The second trial (120 participants), at moderate risk of bias, compared enriched skim milk powder (glycomacropeptide and G600 milk fat extract) to non-enriched skim milk and lactose powders for treating chronic gout. There were no between-group differences in gout attack frequency over 3 months [MD −0.21 (95% CI −0.76 to 0.34)] or withdrawals due to adverse events [relative risk 1.27 (95% CI 0.53 to 3.03)]. Conclusion. While there is observational evidence for an association between lifestyle risk factors and gout development, there are no high quality trials to support or refute the use of lifestyle interventions for treating acute or chronic gout.