Evidence map›Paper›PMID 32741131›Full record

SynthesisArthritis care & research2021

Efficacy and Safety of Pharmacologic Interventions in Patients Experiencing a Gout Flare: A Systematic Review and Network Meta-Analysis.

Linan Zeng, Anila Qasim, Tuhina Neogi, John D Fitzgerald, Nicola Dalbeth, Ted R Mikuls, Gordon H Guyatt, Romina Brignardello-Petersen

Open access · bronzeAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Arthritis care & research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Non-steroidal anti-inflammatory drugs for acute gout.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Gout.The New England journal of medicine · 2022
    Review
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 4 countries.

Linan ZengWest China Second University Hospital, Sichuan University, Chengdu, China, and McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0001-9892-2000
Anila QasimMcMaster University, Hamilton, Ontario, Canada.
Tuhina NeogiBoston University, Boston, Massachusetts.ORCID 0000-0002-9515-1711
John D FitzgeraldUniversity of California, Los Angeles and VA Greater Los Angeles Health Care System, Los Angeles, California.ORCID 0000-0002-8419-7538
Nicola DalbethUniversity of Auckland, Auckland, New Zealand.ORCID 0000-0003-4632-4476
Ted R MikulsUniversity of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha.ORCID 0000-0002-0897-2272
Gordon H GuyattMcMaster University, Hamilton, Ontario, Canada.
Romina Brignardello-PetersenMcMaster University, Hamilton, Ontario, Canada.
McMaster University · CABoston University · USSichuan University · CNUniversity of Auckland · NZUniversity of California, Los Angeles · USVA Nebraska Western Iowa Health Care System · US

Funding

Research and Evaluation Support Core Unit (RESCU Core)P30AR072571 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Michael Paul Lavalley · 2019 to 2026
$6.9M
NIAMS NIH HHS P30 AR072571
6 · The paper itself

Abstract

objectiveTo compare the relative efficacy and safety of pharmacologic antiinflammatory interventions for gout flares.

methodsWe searched Ovid Medline, Embase, and Cochrane library for randomized controlled trials (RCTs) that compared pharmacologic antiinflammatory treatment of gout flares. We conducted a network meta-analysis (NMA) using a frequentist framework and assessed the certainty of evidence and made conclusions using the Grading of Recommendations Assessment, Development, and Evaluation for NMA.

resultsIn the 30 eligible RCTs, canakinumab provided the highest pain reduction at day 2 and at longest follow-up (mean difference relative to acetic acid derivative nonsteroidal antiinflammatory drugs [NSAIDs] -41.12 [95% confidence interval (95% CI) -53.36, -29.11] on a 0-100 scale at day 2, and mean difference -12.84 [95% CI -20.76, -4.91] at longest follow-up; both moderate certainty; minimum important difference -19). Intravenous or intramuscular corticosteroids were inferior to canakinumab but may be better than the other commonly used interventions (low to very low certainty). For joint tenderness, canakinumab may be the most effective intervention at day 2. Acetic acid derivative NSAIDs improved joint swelling better than ibuprofen NSAIDs at day 2 (mean difference -0.29 [95% CI -0.56, -0.02] on a 0-4 scale; moderate certainty) and improved patient global assessment (PtGA) greater than ibuprofen NSAIDs at the longest follow-up (mean difference -0.44 [95% CI -0.86, -0.02]; moderate).

conclusionCanakinumab may be superior to other alternatives and intravenous or intramuscular corticosteroids may be the second best in pain reduction. Acetic acid derivative NSAIDs may be superior to ibuprofen NSAIDs in improving joint swelling and PtGA.

Indexed as

AdultAgedAnti-Inflammatory AgentsFemaleGoutGout SuppressantsHumansMaleMiddle AgedRandomized Controlled Trials as TopicRemission InductionSymptom Flare UpTreatment OutcomeAnti-Inflammatory AgentsGout Suppressants

Identifiers

PMID32741131
PMCPMC10572733
OpenAlexW3046281783

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.