Pharmacological overview for therapy of gout and hyperuricemia
Keywords:
inflammatory arthritis, urate lowering drugs, uricosuric drugs, urate synthesis inhibitors, uric acidAbstract
Hyperuricemia & gout are disease conditions marked by over production and reduced excretion of uric acid. These conditions are linked with unhealthy lifestyle, Hypertension, Diabetes Mellitus, Metabolic syndrome, Cardiovascular & Chronic renal disease. Thus controlling & monitoring uric acid level becomes important. Development in the technology have led to greater insights into the pathophysiology of gout & hyperuricemia. Now we have a better understanding of involvement of interleukin 1β in inflammatory process of gout. Thus with better understanding newer therapeutic targets are being explored for treatment of gout & hyperuricemia. The armamentarium of drugs being used in therapy of acute gout here been expanded with recent addition by interleukin-1 inhibitors especially for refractory patients and patients with comorbidities. As these new therapies are evolving we need to focus on improving the use of Allopurinol through patient education and training of physicians in order to minimize development of Allopurinol hypersensitivity syndrome (AHS). Further pretesting of Human leukocyte Antigen- B ( HLA-B*5801*) should be considered in Asian population. Febuxostat being critically new drug needs cautious approach, proper education of patients and Adverse Drug Reaction (ADR) reporting. With entry of Pegloticase there is a new class of drug added for treating hyperuricemia.
Downloads
References
Gassi D, Ferri L, Desideri G, Giosia PD, Cheli P, Pinto RD, et al. Chronic hyperuricemia uric acid deposit and cardiovascular risk. Current Pharmaceutical Design. 2013; 19(13): 2432- 2438.
Kundu AK. Gout in Indian scenario. Chapter 98. In Medicine update 2013 9th edition Association of Physician of India. 2013;
Singh M, Kaushik ML. A review on treatments of Gout for future aspects. Research & Reviews: A Journal of Pharmaceutical Science. 2017; 8(3):1–6p.
Billa G, Dargad R, Mehta A. Prevalence of hyperuricemia in Indian subjects attending hyperuricemia screening programs- A Retrospective Study. J Assoc of Physicians of India; 2018 April; 66(4):43-6.
Gliozzi M, Malara N, Muscoli S, Mollace V. The Treatment of hyperuricemia. International Journal of Cardio International journal of Cardiology. 2016; 213: 23–27: Available from: https://doi.org/10.1016/j.ijcard.2015.08.087
Ridi RE, Tallima H. Physiological functions and pathogenic potential of Uric acid: a review. Journal of advanced research how science improves society. 2017; 8(5): 487–493. Available from: doi: 10.1016/j.jare.2017.03.003
Singh V, Gomez VV, Swamy SG. Approach to a case of hyperuricemia. Aeromedical Decision Making. IND J Aerospace Med. 2010; 54 (1): 40-46.
Gustafsson D, Unwin R. The pathophysiology of hyperuricaemia and its possible relationship to cardiovascular disease, morbidity and mortality. BMC Nephrol. 2013 Jul 29; 14:164.
Katzung BG. Nonsteroidal anti-inflammatory drugs,disease modifying antirheumatic drugs,nonopioid analgesics and drugs used in Gout. In: Katzung BG Basic and clinical pharmacology. 14th ed. India. McGraw Hill education (India) private limited; 2018. p. 659-663.
Ruoff G, Edwards NL. Overview of serum uric acid treatment targets in Gout: why less than 6mg/dl? Postgraduate Medicine. 2016; 128(7): 706-715. Available from: https://doi.org/10.1080/00325481.2016.12217321
Leung YY, Yao Hui LL, Kraus VB. Colchicine-update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum. 2015;45(3):341-350. Available from: https://doi.org/10.1016/j.semarthrit.2015.06.013
Dalbeth N, Lauterio TJ, Wolfe HR. Mechanism of action of colchicine in the treatment of Gout. Clin Ther. 2014; 36(10): 1465-79. doi: 10.1016/j.clinthera.2014.07.017.
Janssen CA, Voshaar MAHO, Vonkeman HE, Jansen TLTA, Janssen M, Kok MR, et al. Anakinra for the treatment of acute Gout flares: a randomized, double- blind, placebo-controlled, active-comparator, non-inferiority trial. Rheumatology original article. 2019; 58(8): 1344–1352. Available from: https://doi.org/10.1093/rheumatology/key402
Schumacher HR Jr, Evans RR, Saag KG, Clower J, Jennings W, Weinstein SP, Yancopoulos GD, Wang J, Terkeltaub R. Rilonacept (interleukin-1 trap) for prevention of gout flares during initiation of uric acid-lowering therapy: results from a phase III randomized, double-blind, placebo-controlled, confirmatory efficacy study. Arthritis Care Res (Hoboken). 2012; 64(10): 1462-70. Available from: doi: 10.1002/acr.21690.
Terkeltaub RA, Schumacher HR, Carter JD, Baraf HS, Evans RR, Wang J, et al. Rilonacept in the treatment of acute Gouty arthritis: a randomised, controlled clinical trial using Indomethcin as active comparator. Arthritis res ther. 2013; 15(1): R25. Available from: doi: 10.1186/ar4159.
Maldonado BP, Alexender S. Canakinumab in treatment of Gout. Int. J. Clin. Rheumatol. 2011; 6(6): 605-615.
Stamp LK, Taylor WJ, Jones PB, Docherty JL, Drake J, Frampton C, et al. Starting dose is a risk factor for Allopurinol hypersensitivity syndrome a proposed safe starting dose of Allopurinol. Arthritis & Rheumatism. 2012; 64(8); 2529-2536
Stamp LK, Barclay ML. How to prevent allopurinol hypersensitivity reactions? Rheumatology (Oxford). 2018 Jan 1;57(suppl_1):i35-i41. doi: 10.1093/rheumatology/kex422.
American college of rheumatology guidelines for management of government part 1 systematic non pharmacological and pharmacologic therapeutic approaches and hyperuricemia. Arthritis Care Res (Hobaken). 2012; 64(10): 1431-1446. Available from: Doi: 10.1002/Acr.21772 2012
Poon SH, Hall HA, Zimmermann B. Approach to the treatment of hyperuricemia. Med Health R I. 2009 Nov;92(11):359-62. Medicine & Health/ Rhode Island. 2009 ; 92(11): 359-62.
Sattui SE, Gaffo AL. Treatment of hyperuricemia in Gout: current therapeutic options, latest developments and clinical implications. Ther Adv Musculoskelet Dis. 2016; 8(4): 145–159. Available from: doi: 10.1177/1759720X16646703.
White WB, Saag KG, Becker MA, Borer JS, Gorelick PB, Whelton A, et al. Cardiovascular safety of Febuoxstat or Allopurinol in patient with Gout. The new England journal of Medicine. 2018; 378: 1200-10. Available from: DOI;10.1056/NEJMoa1710895.
Uloric(Febuoxstat) [package insert]. Deerfield, IL60015: Takeda pharmaceuticals America,Inc; 2019 Feb.
Benn CL, Dua P, Gurrell R, Loudon P, Pike A, Storer RI, Vangjeli C. Physiology of hyperuricemia and urate lowering treatments. Front. Med. 2018; May31; 5: 160. Available from: doi: 10.3389/fmed.2018.00160.
Deeks ED. Lesinurad; A review in hyperuricemia of Gout. Drugs and aging. 2017; 34(5): 401-410. Available from: doi: 10.1007/s40266-017-0461-y.
Gupta A, Sharma PK, Misra AK, Singh S. Lesinurad a significant advancement or just another addition to existing therapies of Gout?. Journal of Pharmacology & Pharmacotherapeutics. 2016; 7(4): 155–158. Available from: doi: 10.4103/0976-500X.195897
Perez-Ruiz F, Jansen T, Tausche A-K, Juarez- Campo MJ, Gurunath RK, Richette P. Efficacy and safety of Lesinurad for the treatment of hyperuricemia in Gout. Drugs in context: rigorous rapid responsive. 2019; 8: 212581. Available from: doi: 10.7573/dic.212581
Terkeltaub R.A., Schumacher H.R., Carter J.D. et al. Rilonacept in the treatment of acute gouty arthritis: a randomized, controlled clinical trial using indomethacin as the active comparator. Arthritis Res Ther 15, R25 (2013). Available from: doi:10.1186/ar4159
Shahid H, Singh JA. Investigational drugs for hyperuricemia. Expert Opin Investig Drugs. 2015;24(8):1013-30. doi: 10.1517/13543784.2015.1051617.
Khanna D., Fitzgerald J. D., Khanna P. P., Bae S., Singh M. K., Neogi T. et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012; 64(10): 1431–1446. Available from: doi:10.1002/acr.21772.NIH-PA2012
Golenbiewski J, Keenan RT. Moving the needle: improving the care of the gout patient.Rheumatol Ther. 2019; 6 (2): p.179-193. doi: 10.1007/s40744-019-0147-5.
Ea HK, Richette P. Critical appraisal of the role of pegloticase in the management of gout. Open Access Rheumatology: Research and Reviews 2012;4:63–70. Available from: doi: 10.2147/OARRR.S1743
Shannon JA, Cole SW. The annalscom Pegloticase: A Novel Agent for Treatment-Refractory Gout. The annals of pharmacotherapy. 2012;3. 46. 2012;3. 46.
Guttmann A, Krasnokutsky S, Pillinger MH, Berhanu A. Pegloticase in gout treatment - safety issues, latest evidence and clinical considerations. Ther Adv Drug Saf. 2017 Dec;8(12): 379-388. Available from: doi: 10.1177/2042098617727714.
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
