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Urate-lowering therapy for asymptomatic hyperuricaemia: A need for caution
1Department of Medicine, University of Otago, Christchurch, 2 Riccarton Ave, P.O. Box 4345, Christchurch, New Zealand.
Seminars in Arthritis and Rheumatism
|September 5, 2016
Summary
Treating asymptomatic hyperuricaemia is premature due to unclear causal roles and potential adverse effects. More evidence is needed before widespread treatment for non-gout diseases.
Area of Science:
- Nephrology
- Cardiology
- Rheumatology
Background:
- Hyperuricemia is increasingly associated with hypertension, cardiovascular disease, and kidney disease.
- The potential benefit of urate-lowering therapy for these non-gout diseases is under investigation.
- Current recommendations for urate-lowering therapy vary by country.
Purpose of the Study:
- To discuss the complexities and current limitations in treating asymptomatic hyperuricemia.
- To evaluate the evidence regarding the causal role of urate in non-gout diseases.
- To assess the risks and benefits of urate-lowering therapies.
Main Methods:
- A literature search was conducted using PubMed with the term "asymptomatic hyperuricaemia" in January 2016.
Main Results:
- There is no consistent definition for hyperuricemia or asymptomatic hyperuricemia.
- The causal role of urate in non-gout diseases remains largely unknown.
- Evidence on the effects of urate lowering on disease progression is lacking.
- Urate-lowering therapies carry potential risks, including allopurinol hypersensitivity syndrome.
Conclusions:
- Treating asymptomatic hyperuricemia appears premature given the current lack of evidence.
- Further research is required to clarify the role of urate and the efficacy/safety of urate-lowering therapies.
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