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Medications for gout and its comorbidities: mutual benefits?

Kazuki Yoshida1,2, Hyon K Choi2,3, Daniel H Solomon1,2,4

  • 1Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital.

Current Opinion in Rheumatology
|January 5, 2021
PubMed

Insights

Low-dose colchicine shows cardiovascular benefits, potentially expanding its use beyond gout. SGLT-2 inhibitors may help diabetic patients with gout, while urate-lowering therapy

Area of Science:

  • Rheumatology
  • Cardiology
  • Nephrology

Background:

  • Management of patients with multiple chronic conditions (multimorbidity) requires careful consideration of medication interactions and benefits.
  • Gout medications are increasingly being investigated for their potential roles in managing other diseases, and vice versa.

Purpose of the Study:

  • To review recent literature on the management of multimorbid patients with gout.
  • To explore the repurposing of gout medications for comorbidities and vice versa.

Main Methods:

  • Literature review of recent studies.
  • Analysis of clinical trial data and observational studies.

Main Results:

  • Low-dose colchicine demonstrated significant cardiovascular benefits in patients post-myocardial infarction and with stable coronary artery disease.
  • Urate-lowering therapy (ULT) showed no renal protection in patients without gout.
  • Allopurinol did not improve glomerular filtration rate in patients with chronic kidney disease.
  • SGLT-2 inhibitors showed a protective effect against gout flares in patients with diabetes and cardiovascular disease.

Conclusions:

  • Colchicine's role may extend to cardiovascular disease (CVD) management beyond gout flare prevention.
  • The renal benefit of ULT in gout patients requires further clarification.
  • SGLT-2 inhibitors may offer benefits for diabetic patients with gout as a comorbidity.
Abstract

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