Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study

Wang C, Sun W, Dalbeth N, Wang Z, Wang X, Ji X, Xue X, Han L, Cui L, Li X, Liu Z, Ji A, He Y, Sun M, Li C · Arthritis Research & Therapy

On the two co-primary outcomes — urine pH and serum urate — the tart cherry mixture matched plain citrate and sodium bicarbonate, with no significant difference between groups. It did beat both on CRP at week 12 (p < 0.01) and on the urine albumin/creatinine ratio (against bicarbonate p < 0.001, against citrate p = 0.034), though its albumin ratio started at more than twice theirs (7.42 against 3.01 and 3.29 mg/g) and finished lowest. Both citrate-containing arms had fewer gout flares than bicarbonate (p = 0.024 and p = 0.033) and did not differ from each other. The metabolic-syndrome measures the trial was built on — blood pressure, glucose, HOMA-IR, cholesterol — improved within the cherry arm and showed no between-group difference at any visit. Adverse events were comparable.

Population

Men with gout and fasting urine pH <= 6, starting febuxostat

Intervention

Tart cherry supplementary citrate (TaCCi) mixture for 12 weeks

Comparator

Citrate mixture, or sodium bicarbonate

Limitations

Open-label, single centre, men only with eGFR above 60, 12 weeks, and the tart cherry is bundled inside a citrate mixture — so the trial cannot separate the cherry from the citrate on any endpoint. Everyone was starting febuxostat, which is where the urate fall came from. The albumin-ratio result is the one that separated and the one whose randomisation was most uneven at baseline. Publicly funded by Chinese national and provincial research programmes; one author declares industry payments outside this work. Registered ChiCTR2100050749.