Gout-Related Chinese Herbal Medicine/Chinese Patent Medicine Exposure and Documented Refractory Gout Status: A Retrospective Real-World Cohort Study of Outcome Completeness and Surveillance Intensity
- 1Department of Rheumatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
Abstract
Purpose: To examine the association between sustained gout-related Chinese herbal medicine (CHM) or Chinese patent medicine (CPM) exposure and documented refractory gout (RG), and determine how outcome completeness and surveillance intensity affected the estimate.
Patients and Methods: This retrospective real-world cohort included 600 patients with gout. Sustained exposure was gout-related CHM/CPM use for at least 3 months; shorter or no documented exposure comprised the comparator group. RG adjudication integrated longitudinal serum urate (SUA), treatment response, flares, tophi/imaging, and clinician records. Analyses included regression, stabilized inverse probability of treatment weighting (IPTW), missing-outcome and tipping-point analyses, and restriction by SUA testing frequency.
Results: RG was adjudicable in 295/300 sustained-exposure patients and 143/300 comparators. RG occurred in 149/295 (50.5%) and 90/143 (62.9%), respectively (unadjusted OR=0.601, 95% CI 0.399–0.905; P=0.014). Point estimates remained below 1 after covariate adjustment (OR=0.653, 95% CI 0.424–1.008; P=0.054) and stabilized IPTW (OR=0.699, 95% CI 0.462–1.058; P=0.091), although both 95% CIs included 1.0. The estimate among patients with at least four distinct SUA testing dates was directionally similar but imprecise (OR=0.737, 95% CI 0.232–2.214; P=0.620). The missing-outcome tipping point was 62/157 (39.5%). No duration-response pattern was evident across exposure categories, and regimens were heterogeneous.
Conclusion: Sustained CHM/CPM exposure was associated with a lower documented RG proportion in the outcome-adjudicable analysis. Adjustment and sensitivity analyses reduced statistical precision, although the estimates remained below 1. Prospective studies are needed to evaluate this adjunctive treatment pattern.
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BibTeX
@article{huang2026goutrelated,
title = {{Gout-Related Chinese Herbal Medicine/Chinese Patent Medicine Exposure and Documented Refractory Gout Status: A Retrospective Real-World Cohort Study of Outcome Completeness and Surveillance Intensity}},
author = {Yidi Huang and Cunxiang Xie and Hao Wang and Luyuan Gao and Mingxuan Liu and Luming Zhao and Jinying Fang and Hailong Wang},
journal = {Journal of Inflammation Research},
year = {2026},
month = oct,
doi = {10.2147/jir.s635596},
url = {https://doi.org/10.2147/jir.s635596},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Gout-Related Chinese Herbal Medicine/Chinese Patent Medicine Exposure and Documented Refractory Gout Status: A Retrospective Real-World Cohort Study of Outcome Completeness and Surveillance Intensity
AU - Yidi Huang
AU - Cunxiang Xie
AU - Hao Wang
AU - Luyuan Gao
AU - Mingxuan Liu
AU - Luming Zhao
AU - Jinying Fang
AU - Hailong Wang
PY - 2026
DA - 2026/10/27
JO - Journal of Inflammation Research
DO - 10.2147/jir.s635596
UR - https://doi.org/10.2147/jir.s635596
AB - Purpose: To examine the association between sustained gout-related Chinese herbal medicine (CHM) or Chinese patent medicine (CPM) exposure and documented refractory gout (RG), and determine how outcome completeness and surveillance intensity affected the estimate. Patients and Methods: This retrospective real-world cohort included 600 patients with gout. Sustained exposure was gout-related CHM/CPM use for at least 3 months; shorter or no documented exposure comprised the comparator group. RG adjudication integrated longitudinal serum urate (SUA), treatment response, flares, tophi/imaging, and clinician records. Analyses included regression, stabilized inverse probability of treatment weighting (IPTW), missing-outcome and tipping-point analyses, and restriction by SUA testing frequency. Results: RG was adjudicable in 295/300 sustained-exposure patients and 143/300 comparators. RG occurred in 149/295 (50.5%) and 90/143 (62.9%), respectively (unadjusted OR=0.601, 95% CI 0.399–0.905; P=0.014). Point estimates remained below 1 after covariate adjustment (OR=0.653, 95% CI 0.424–1.008; P=0.054) and stabilized IPTW (OR=0.699, 95% CI 0.462–1.058; P=0.091), although both 95% CIs included 1.0. The estimate among patients with at least four distinct SUA testing dates was directionally similar but imprecise (OR=0.737, 95% CI 0.232–2.214; P=0.620). The missing-outcome tipping point was 62/157 (39.5%). No duration-response pattern was evident across exposure categories, and regimens were heterogeneous. Conclusion: Sustained CHM/CPM exposure was associated with a lower documented RG proportion in the outcome-adjudicable analysis. Adjustment and sensitivity analyses reduced statistical precision, although the estimates remained below 1. Prospective studies are needed to evaluate this adjunctive treatment pattern.
SN - 1178-7031
ER -