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Related Experiment Video

Updated: Oct 25, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Interventions for tophi in gout.

Melonie K Sriranganathan¹, Ophir Vinik², Jordi Pardo Pardo³

¹Rheumatology Service, Department of General Medicine, Changi General Hospital, Singapore City, Singapore.

The Cochrane Database of Systematic Reviews

|August 11, 2021

Summary

This summary is machine-generated.

Pegloticase may help resolve tophi in gout, but leads to more adverse event withdrawals. Lesinurad plus febuxostat might benefit tophi resolution, unlike lesinurad plus allopurinol. More research is needed for gout tophi treatments.

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Published on: May 9, 2019

Area of Science:

Rheumatology
Gout Management
Clinical Trials

Background:

Tophi are a manifestation of untreated or uncontrolled gout.
This review updates previous findings on gout tophi treatments.

Purpose of the Study:

To assess the benefits and harms of non-surgical and surgical treatments for tophi in gout.
Evaluate pegloticase, lesinurad, and febuxostat interventions.

Main Methods:

Updated systematic search of CENTRAL, MEDLINE, and Embase databases.
Included randomized controlled trials (RCTs) and controlled clinical trials in adults.
Assessed risk of bias and synthesized evidence for treatment efficacy and safety.

Main Results:

Biweekly pegloticase demonstrated moderate-certainty evidence for tophi resolution but increased adverse event withdrawals.
Monthly pegloticase showed potential for tophi resolution with similar adverse events but higher withdrawal rates.
Lesinurad (200mg or 400mg) combined with allopurinol showed no significant benefit for tophi resolution.
Lesinurad 400mg plus febuxostat indicated potential benefit for tophi resolution compared to lesinurad 200mg plus febuxostat, with no significant difference in adverse events.

Conclusions:

Pegloticase is likely beneficial for tophi resolution in gout, despite increased withdrawals due to adverse events.
Lesinurad 400mg plus febuxostat may offer benefits for tophi resolution over lesinurad 200mg plus febuxostat.
Further RCTs are needed to clarify the efficacy and safety of interventions for managing gout tophi, given the current limited data.