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27-07-2024 | Hyperuricemia and Gout | Review Article

Managing Gout in Patients with Metabolic Syndrome

Authors: Esther Ebstein, Sébastien Ottaviani

Published in: Drugs & Aging | Issue 8/2024

Abstract

Gout is characterized by monosodium urate (MSU) crystal deposition secondary to hyperuricemia. Gout is associated with metabolic syndrome (MetS) and its related comorbid conditions such as cardiovascular disease (CVD). Major advances have been made in the comprehension of the link between MetS and gout. Despite observational studies suggesting an association between MetS-related conditions and hyperuricemia, there is no proof of causality. Most studies using Mendelian randomization did not find hyperuricemia as a causal factor for MetS-related conditions. In contrast, these conditions were found associated with hyperuricemia, which suggests a reverse causality. Among patients with gout, this high CVD risk profile implies the need for systematic screening for MetS-related conditions. Most international guidelines recommend systematic screening for and care of CVD and related risk factors in patients with gout. Some anti-hypertensive agents, such as losartan and calcium channel blockers, are able to decrease serum urate (SU) levels. However, there are potential interactions between gout management therapies and the treatment of metabolic diseases. Some data suggest that anti-inflammatory drugs used for gout flare treatment, such as colchicine or canakinumab, might have benefits for CVD. Regarding the impact of urate-lowering therapies on CVD risk, recent studies found a similar CVD safety profile for allopurinol and febuxostat. Finally, sodium-glucose cotransporter-2 inhibitors are promising for gout because of their ability to decrease SU levels and risk of recurrent flares. In this review, we focus on the clinical challenge of managing MetS in patients with gout, particularly older patients with co-medications.

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Title: Managing Gout in Patients with Metabolic Syndrome
Authors: Esther Ebstein
Sébastien Ottaviani
Publication date: 27-07-2024
Publisher: Springer International Publishing
Keywords: Hyperuricemia and Gout
Obesity
Gout
Coronary Heart Disease
Hypertension
Hypertriglyceridemia
Prediabetes
Type 2 Diabetes
Metabolic Diseases in General Practice
Lifestyle Modification for Metabolic Syndrome
Published in: Drugs & Aging / Issue 8/2024
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI: https://doi.org/10.1007/s40266-024-01132-x

EASD 2024

Springer Medicine

Managing Gout in Patients with Metabolic Syndrome

Abstract

EASD 2024

Springer Medicine

Abstract

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