Treatment of refractory gout with TNF-α antagonist etanercept combined with febuxostat.

ABSTRACT

A male patient, diagnosed as acute gouty arthritis with hypertension, gastrointestinal fungal infection, gastric ulcer, and other diseases, received the following treatment low purine diet, alkalization of urine, omeprazole to inhibit gastric acid secretion, low-dose colchicine to relieve joint pain, febuxostat to reduce uric acid synthesis, losartan potassium to reduce blood pressure, atorvastatin calcium tablet to lower lipid, cefmendoxime proxetil to resist infection, and TNF-α antagonist etanercept 25 mg subcutaneous injection two times a week (with 72 hours interval) for two weeks. As a result, the patient responded well to TNF antagonist etanercept. The joint pain was significantly relieved one day after treatment and completely relieved after five days. Two weeks later, the results of C-reaction protein (CRP) and blood routine examination returned to normal. We drawed conclusions as follows TNF antagonists etanercept can alleviate the acute inflammatory response of gouty arthritis and ensure uric acid-lowering therapy. However, the safety and effectiveness of the drug in the treatment of acute, complex, and refractory gout still need to be confirmed by randomized, multi-center, large sample clinical controlled study. This case report only supplies a new reference scheme for the treatment of similar diseases.