Uricosuric Drugs: Once and Future Therapy for Hyperuricemia?
Uricosuric Drugs: Once and Future Therapy for Hyperuricemia?
Some drugs used commonly for other conditions exert a uricosuric action as a secondary property. Losartan, an angiotensin II receptor antagonist, inhibits URAT1 and GLUT9. Fenofibrate, a cholesterol-lowering drug, may also increase urinary uric acid excretion by also inhibiting URAT1. Combination use of these agents with allopurinol 200 mg twice a day or benzbromarone 50 mg once daily did result in significantly decreased serum uric acid levels and increased uric acid excretion, although the additional hypouricemic effect may be modest. Nevertheless, these options are attractive for the many gouty patients who suffer from hypertension and hyperlipidemia. Corticosteroids are mildly uricosuric and aspirin has already been mentioned. It serves as a prototype for the long sought anti-inflammatory drug, which is also a uricosuric agent. Unfortunately, aspirin causes urate retention at the low doses commonly used, and it now has almost no place in the management of gout.
Secondary Uricosurics
Some drugs used commonly for other conditions exert a uricosuric action as a secondary property. Losartan, an angiotensin II receptor antagonist, inhibits URAT1 and GLUT9. Fenofibrate, a cholesterol-lowering drug, may also increase urinary uric acid excretion by also inhibiting URAT1. Combination use of these agents with allopurinol 200 mg twice a day or benzbromarone 50 mg once daily did result in significantly decreased serum uric acid levels and increased uric acid excretion, although the additional hypouricemic effect may be modest. Nevertheless, these options are attractive for the many gouty patients who suffer from hypertension and hyperlipidemia. Corticosteroids are mildly uricosuric and aspirin has already been mentioned. It serves as a prototype for the long sought anti-inflammatory drug, which is also a uricosuric agent. Unfortunately, aspirin causes urate retention at the low doses commonly used, and it now has almost no place in the management of gout.
Source...