Should our approach to diuretic using in patients with gout change?

Excerpt

We read with interest the recent article by Ranieri et al. [1]. The intention of the authors was to investigate the impact of diuretic therapy on the response of urate-lowering drugs (ULDs) in patients with gout. According to the results of this study, diuretic therapy did not impair response to ULDs. Also, there was no significant effect of diuretic use on the achievement of serum urate (SU) targets or on the maximum doses of ULDs. However, it is known that the European League Against Rheumatism (EULAR) has reported its concern in regard to the use of diuretics in patients with gout and recommends substitution of diuretic to losartan or calcium channel blockers if gout is diagnosed in a hypertensive patient receiving loop or thiazide diuretics [2]. For this reason, we believe that the results of this study, which reported the incompatibility with the recommendations of known and accepted organizations, should be interpreted carefully as it may bring a question mark to daily clinical practice. …