Hypouricemic effectiveness of synbiotic in the complex treatment in gout patients
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 1
Abstract
Objective — to evaluate the hypouricemic effects of the combination of synbiotic and allopurinol versus monotherapy with allopurinol in gout patients. Materials and methods. The examinations involved 130 patients (mean age (55.5 ± 9.4) years old) with gout (mean duration (7.7 ± 7.1) years). The gout diagnosis was based on the ACR criteria (2016). The control group consisted of 25 practically healthy men of the corresponding age. Patients with gout who have not reached the target uricemia level after 6 weeks of treatment with allopurinol were included in the treatment groups. The main group (n = 68) included patients who continued to take allopurinol in a dose of 300 mg per day with up-titration of 100 mg per month, and additionally took the synbiotic 1 capsule three times a day. The comparison group (n = 62) consisted of patients receiving allopurinol monotherapy. The treatment duration was 3 months. Qualitative and quantitative parameters of intestinal microbiote were analysed based on the data of bacteriological inoculation of faeces. The effectiveness of therapy was assessed by the levels of uricemia, C-RP, and the degree of dysbiotic changes in the intestinal microbiocenosis. Results and discussion. After treatment of patients in the main group with synbiotic using, the normalization of the indicators was observed due to the reduction of the concentration of opportunistic microorganisms of the Firmicutes group, obligate anaerobes, Bacteroides spp., Candida and the restoration of protective microflora — lacto- and bifidobacteria. In patients with gout after 3 months of complex treatment with the addition of a synbiotic, the transformation of the structure of the intestinal microbiota in the direction of normalization of qualitative (prevalence of mild degree of violations of microbiota in 50 % of subjects) and quantitative composition, revealed a more pronounced hypouricemic effect relative to the comparison group — the target level of uricemia is achieved twice as often — in 40.3 and 21 % of cases respectively. The additional inclusion of the synbiotic demonstrated an increase in the hypouricemic effect of allopurinol (a decrease in uric acid levels by 18.7 versus 13.3 %, p < 0.01), which was associated with more pronounced anti-inflammatory effect (a decrease in C-RP by 75 versus 26.3 %, p < 0.01). Conclusions. For patients with gout there is a pronounced violation of intestinal microbiota characterized by a combination of deficiency of protective microflora and an increase in obligate anaerobes, gram-positive cocci and fungi of the genus Candida. In patients with gout after 3 months of complex treatment with the addition of a synbiotic, against the background of the normalization of the qualitative and quantitative composition of intestinal microbiota, there is a more pronounced hypouricemic effect — the target level of uricemia is achieved twice as often, which is combined with more pronounced anti-inflammatory effect.
Authors and Affiliations
V. Е. Kondratiuk, O. M. Tarasenko, L. V. Natrus, I. G. Ponomarova
Keywords
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- EP ID EP587930
- DOI 10.30978/UTJ2019-1-75
- Views 91
- Downloads 0
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