Trial reportRheumatology (Oxford, England)2025
Impact of adding urine alkalization therapy to xanthine oxidase inhibitor in gout management: a prospective cohort study.
Trial report in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 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
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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Uric Acid and Chronic Kidney Disease.Kidney medicine · 2026Review
- Effects of adding urinary alkalizer citrate mixture to febuxostat in gout patients with combined-type hyperuricemia and low urine pH: a prospective cohort study.Arthritis research & therapy · 2026Article
- Effects of Citrate Mixture on Gout Flares During Urate-Lowering Therapy Initiation Among Chinese Male Underexcretion-Type Gout Patients: A Prospective Cohort Study.Journal of inflammation research · 2026Article
- Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
objectivesGout patients frequently have decreased urine pH, related to metabolic syndrome (MetS) and chronic kidney disease. Here, we aimed to investigate whether the addition of urine alkalization to urate-lowering therapy (ULT) is associated with improvements in albuminuria, gout flares or MetS outcomes in men with gout and low urinary pH (pH < 6.2).
methodsA prospective cohort study enrolled 385 participants starting ULT with febuxostat (initially 20 mg daily, escalated to 40 mg daily if serum urate ≥360 µmol/l), with or without alkalization based on patient preference using a 3.5 g bid citrate mixture. Participants were followed every 4 weeks to week 12. The primary outcome was urine albumin-to-creatinine ratio (UACR) at week 12.
resultsIn total, 343 participants completed the week 12 visit (137 alkalization, 206 controls). At week 12, compared with controls, participants receiving alkalization required a significantly lower febuxostat dose (by ∼20%) but had no significant difference in serum urate at target <360 µmol/l. Urine pH increased significantly in the alkalization group from week 4 (P < 0.001). At week 12, the alkalization group had a significantly lower UACR compared with control (P < 0.001), without significantly different eGFR. Participants in the alkalization group experienced fewer gout flares and had lower pain visual analogue scale scores (P < 0.001). There were lower serum triglyceride levels (P < 0.01) and higher HDL-C levels (P < 0.001) in the alkalization group. No other differences in metabolic outcomes were observed.
conclusionUrine alkalization was associated with lower UACR, fewer gout flares, and improved serum lipid profile in febuxostat-treated men with gout and low urine pH.
trial registrationChiCTR, http://www.chictr.org.cn, ChiCTR2100043573.
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