Effect of proton pump inhibitors on acute gouty arthritis attacks in patients with a history of gout
Objective To investigate the effect of proton pump inhibitors(PPIs)on acute gouty arthritis attacks in patients with a previous history of gout under fasting conditions.Methods From January 2015 to September 2020,at the First Affiliated Hospital of Guangxi Medical University,43 patients with a confirmed diagnosis of gout who received PPIs treatment during fasting periods were enrolled in the study group,while another 43 patients with a confirmed diagnosis of gout who did not receive PPIs treatment during fasting peri-ods were included in the control group.Statistical analysis was then performed on relevant indicators between the two groups.Results The incidence of acute gouty arthritis attacks in the study group was significantly higher than in the control group.Compared with the control group,patients in the acute gouty arthritis attack group had increased serum uric acid and serum creatinine levels,along with decreased HCO3-levels(P＜0.05).In the PPIs treatment group,biochemical indices after PPIs treatment showed higher serum uric acid and serum creatinine levels(P＜0.05),while serum HCO3-,blood K,blood Na+and blood Cl-levels were lower than before treatment(P＜0.05).Conclusion The use of PPIs under fasting conditions in patients with a previous history of gout may trigger acute gouty arthritis attacks.It is speculated that PPIs,under cer-tain conditions may induce acute gouty arthritis attacks by inhibiting the activity of H+-K+-ATPase in the renal tubules,impacting the acid-base balance in the renal tubules,and leading to impaired uric acid excretion and subsequent hyperuricemia.
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