Evidence map›Paper›PMID 35445840›Full record

ArticleRheumatology international2022

ACTH vs steroids for the treatment of acute gout in hospitalized patients: a randomized, open label, comparative study.

Dimitrios Daoussis, Panagiotis Kordas, George Varelas, Marina Michalaki, Anny Onoufriou, Irene Mamali, George Iliopoulos, Konstantinos Melissaropoulos, Konstantinos Ntelis, Dimitrios Velissaris and 6 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Rheumatology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04306653 (ACTH vs Betamethasone for the Treatment of Acute Gout in Hospitalized Patients), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 27% 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.

NCT04306653 naunknown statusnot on this map

ACTH vs Betamethasone for the Treatment of Acute Gout in Hospitalized Patients: A Randomized, Open Label, Comparative Study

TypeinterventionalSponsorUniversity of PatrasRan2018 to 2020Enrolled60ConditionsGout AttackArmsACTH, Betamethasone
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 11 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Dimitrios DaoussisDepartment of Rheumatology, Patras University Hospital, University of Patras Medical School, Patras, Greece. jimdaoussis@hotmail.com.ORCID 0000-0001-8027-3655
Panagiotis KordasNorth Sector Health Center, Patras, Greece.ORCID 0000-0003-3924-2624
George VarelasData and Media Lab, Department of Electrical and Computer Engineering, University of Peloponnese, Tripoli, Greece.ORCID 0000-0002-6141-2020
Marina MichalakiDepartment of Endocrinology, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0003-2073-8523
Anny OnoufriouDepartment of Microbiology, Patras University Hospital, University of Patras Medical School, Patras, Greece.
Irene MamaliDepartment of Endocrinology, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0001-6826-887X
George IliopoulosDepartment of Rheumatology, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0001-9857-0842
Konstantinos MelissaropoulosDepartment of Rheumatology, Agios Andreas Hospital, Patras, Greece.ORCID 0000-0002-4891-0623
Konstantinos NtelisDepartment of Rheumatology, Agios Andreas Hospital, Patras, Greece.ORCID 0000-0001-6965-0616
Dimitrios VelissarisDepartment of Internal Medicine, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0002-9319-323X
Giannis TzimasData and Media Lab, Department of Electrical and Computer Engineering, University of Peloponnese, Tripoli, Greece.ORCID 0000-0002-4073-7256
Panagiotis GeorgiouDepartment of Rheumatology, Agios Andreas Hospital, Patras, Greece.ORCID 0000-0002-4749-7777
Sofia VamvakopoulouDepartment of Microbiology, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0002-8896-401X
Fotini PaliogianniDepartment of Microbiology, Patras University Hospital, University of Patras Medical School, Patras, Greece.ORCID 0000-0001-5112-1724
Andrew P Andonopoulos *Professor Emeritus, University of Patras, Patras, Greece.ORCID 0000-0003-1794-8554
Neoklis Georgopoulos *Department of Endocrinology, Patras University Hospital, University of Patras Medical School, Patras, Greece.
University of Patras · GRAgios Andreas Hospital · GRUniversity of Peloponnese · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The management of acute gout in the hospital setting may be challenging since most patients are elderly with multiple unstable comorbidities. However, there are no prospective clinical trials for hospitalized patients with gout to guide optimal management. Evidence indicates that steroids or adrenocorticotropic hormone (ACTH) may be effective and safe therapeutic options for these patients. This study aimed at directly comparing the efficacy and safety of ACTH vs betamethasone for the treatment of gout in hospitalized patients. This is the first prospective clinical trial for hospitalized patients with gout. We designed a randomized, open label study to assess the efficacy and safety of a single intramuscular injection of either ACTH or betamethasone in hospitalized patients with acute gout. Primary efficacy endpoints were the change in intensity of pain as recorded using a Visual Analogue Scale (VAS) at baseline compared to 24 h (ΔVAS24h), and 48 h. Moreover, we assessed safety and effects on the hypothalamic-pituitary-adrenal (HPA) axis, glucose and lipid homeostasis, bone metabolism, electrolytes and renal function. 38 patients were recruited. Both treatments were highly effective. The mean ± SE ΔVAS24h and ΔVAS48h for ACTH was 4.48 ± 0.29 and 5.58 ± 0.26, respectively. The mean ± SE ΔVAS24h and ΔVAS48h for betamethasone was 4.67 ± 0.32 and 5.67 ± 0.28, respectively. Direct comparison between the two groups at 24 h and 48 h did not show statistically significant differences. Both treatments were well tolerated and safe. The effects on all metabolic parameters were mostly minimal and transient for both treatments. However, ACTH may affect less the HPA axis and bone metabolism compared to betamethasone, thus leading to the conclusion that. ACTH and betamethasone are effective and safe for the management of acute gout in hospitalized patients but that ACTH may associate with less disturbance of the HPA axis and bone metabolism. Our data support the use of both drugs as first line treatments for hospitalized patients with gout.Clinical trial registration: ClinicalTrials.gov NCT04306653.

Indexed as

Arthritis, GoutyGoutAdrenocorticotropic HormoneAgedBetamethasoneHumansHypothalamo-Hypophyseal SystemPituitary-Adrenal SystemProspective StudiesSteroidsAdrenocorticotropic HormoneBetamethasoneSteroidsACTHAdrenocorticotropic hormoneBetamethasoneGoutHospitalized patientsSteroids

Identifiers

PMID35445840
OpenAlexW4224212592

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.