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Advances in pharmacotherapies for hyperuricemia
Federica Piani1, Davide Agnoletti1, Claudio Borghi1,2
1Cardiovascular Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Expert Opinion on Pharmacotherapy
|March 31, 2023
Summary
High uric acid levels (hyperuricemia) are a significant risk for heart and kidney disease. Recent evidence suggests treating hyperuricemia may improve cardiovascular and renal outcomes, though further trials are needed.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Hyperuricemia is an independent risk factor for cardiovascular disease (CVD), heart failure, chronic kidney disease (CKD), and cardiovascular mortality.
- Uric acid's role in these conditions is supported by epidemiological and genetic studies.
- Current treatment options for hyperuricemia include xanthine oxidase inhibitors, uricosuric medications, and recombinant uricases.
Approach:
- This review summarizes current therapeutic indications and options for symptomatic and asymptomatic hyperuricemia.
- The authors searched recent literature (2018-2022) for randomized controlled trials and meta-analyses.
- Focus was placed on the cardiovascular and nephroprotective effects of hypouricemic agents.
Key Points:
- Recent trials and meta-analyses support the therapeutic strategy of treating hyperuricemia.
- Hypouricemic agents demonstrate potential cardiovascular and nephroprotective benefits.
- Medications with cardio- and nephroprotective properties can also lower serum uric acid levels.
Conclusions:
- Further large-scale clinical trials are warranted to confirm the role of hypouricemic agents in cardiovascular prevention and renal protection.
- Differentiating hyperuricemia phenotypes may enhance future trial design and results.
- Hypouricemic agents may expand their indications, impacting patient morbidity and mortality.
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