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Cardiac and renal protective effects of urate-lowering therapy

Pascal Richette1,2, Augustin Latourte1,2, Thomas Bardin1,2

  • 1Université Paris 7, UFR médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie.

Rheumatology (Oxford, England)
|December 23, 2017
PubMed

Insights

Urate-lowering therapy (ULT) effects on gout comorbidities like cardiovascular disease and kidney issues are unclear. More large trials are needed to confirm if ULT benefits these conditions.

Area of Science:

  • Nephrology
  • Cardiology
  • Rheumatology

Background:

  • Gout patients frequently have comorbidities, including cardiovascular disease, renal failure, and metabolic syndrome.
  • Hyperuricemia and gout are potentially linked to increased risks of myocardial infarction, renal failure, and cardiovascular events.

Purpose of the Study:

  • To evaluate the impact of urate-lowering therapy (ULT) on comorbidities in gout patients, particularly cardiovascular events and chronic kidney disease.
  • To synthesize existing evidence on ULT's effects on cardiovascular health and kidney function in gout patients.

Main Methods:

  • Review of randomized controlled trials (RCTs) investigating urate-lowering therapies.
  • Analysis of studies examining allopurinol and febuxostat in relation to cardiovascular outcomes and kidney function decline.

Main Results:

  • Some RCTs suggest allopurinol may improve exercise capacity in stable angina and lower blood pressure in adolescents.
  • Evidence is conflicting regarding allopurinol's effect on heart failure and chronic kidney disease progression.
  • A recent trial indicated no benefit from febuxostat for kidney function.

Conclusions:

  • The precise impact of urate-lowering therapy on cardiovascular events and chronic kidney disease in gout patients remains uncertain.
  • Large-scale, randomized, placebo-controlled trials are essential to definitively establish the benefits of ULT for managing gout comorbidities.

Keywords:
allopurinolco-morbiditiesfebuxostatgouturate-lowering therapy

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