ReviewNature reviews. Rheumatology2022
When underlying biology threatens the randomization principle - initial gout flares of urate-lowering therapy.
Review in Nature reviews. Rheumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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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.
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.
Who cites it
10 citing papers in PubMed, 20 citations in OpenAlex.
- Effect of sodium-glucose cotransporter-2 inhibitors on uric acid in patients with heart failure and preserved ejection fraction: a retrospective analysis in real word.BMC cardiovascular disorders · 2026Article
- Impact of Bariatric Surgery on Gout Medication: a Nationwide Cohort Study.Obesity surgery · 2026Article
- Comparative Cardiovascular Safety of Nonsteroidal Anti-Inflammatory Drug Versus Colchicine Use When Initiating Urate-Lowering Therapy Among Patients With Gout: Target Trial Emulations.Arthritis & rheumatology (Hoboken, N.J.) · 2025Article
- Firsekibart as a Prophylactic Treatment for Acute Gout Flare in Participants Initiating Urate-Lowering Therapy: A Phase 2, Randomized, Open-Label, Multicenter, Active-Controlled Trial.ACR open rheumatology · 2025Article
- Treatment-emergent major adverse cardiovascular and thromboembolic events were infrequent during clinical trials of pegloticase.Rheumatology (Oxford, England) · 2025Article
- Dosing practices, pharmacokinetics, and effectiveness of allopurinol in gout patients receiving dialysis: a scoping review.Journal of nephrology · 2025Article
- Acupuncture as an Adjunctive Therapy to Etoricoxib for Patients with Acute Gouty Arthritis: Protocol for a Multicenter Randomized Controlled Trial.Journal of pain research · 2025Article
- The clinical benefits of sodium-glucose cotransporter type 2 inhibitors in people with gout.Nature reviews. Rheumatology · 2024Review
- Comparative Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors for Recurrent Gout Flares and Gout-Primary Emergency Department Visits and Hospitalizations : A General Population Cohort Study.Annals of internal medicine · 2023Article
- Gout Flares and Mortality After Sodium-Glucose Cotransporter-2 Inhibitor Treatment for Gout and Type 2 Diabetes.JAMA network open · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Flare is the dominant feature of gout and occurs because of inflammatory response to monosodium urate crystals; prevention of gout flares should be the major goal of gout care. However, a paradoxical increase in the risk of flare following initiation of urate-lowering therapy presents considerable challenges for proving the expected long-term benefits of flare prevention in clinical trials. Nevertheless, excluding from enumeration flares that occur in the initial post-randomization period (which can last several months to 1 year) can threaten the core benefits of randomization: the characteristics of the remaining participants can differ from those who were randomized, introducing potential bias from confounding (both measured and unmeasured); participants who drop out or die are excluded from the analysis, introducing potential selection bias; and, finally, ignoring initial flares underestimates participants' experience during the trial. This Perspective discusses these issues and recommends measures that will allow for high-level evidence that preserves the randomization principle, to satisfy methodological scrutiny and generate robust evidence-based guidelines for gout care.
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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.