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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

Year: 2026

Type: article

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.

Source: Journal of Inflammation Research

DOI: 10.2147/jir.s635596