Drug-induced hyperuricemia/gout. Part 1: prevalence, pathophysiology, risk factors, clinical pattern


DOI: https://dx.doi.org/10.18565/therapy.2021.6.136-145

Pereverzev A.P., Ostroumova O.D.

1) Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia, Moscow; 2) I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)
Abstract. Intake of medication, mostly diuretics, anti-tuberculosis drugs, salicylates, immunosuppressants, anticancer drugs, etc. could be an often-occured etiological cause of hyperuricemia (HU) and gout pathology arising. In this case, it is meant the drug-induced HU/gout, which are representing an urgent problem in clinical practice. Article considers the groups of medicines able to induce this pathology, the mechanisms of uric acid (UA) increasing in the blood serum during drug intake, risk factors, and clinical manifestations of drug-induced HU/gout. Taking into account, that this form of the disease, like HU/gout caused by other causes, can be asymptomatic for a long time, it is recommended that people with risk factors for of GU/gout development should periodically determine the UA level in the blood serum. The main aims of treatment of the studied pathology are: reducing UA level (<360 μmol/L and <300 μmol/L in patients with severe tofus gout, but not less than 180 μmol/L), achieving regression of symptoms, including relief of acute or chronic arthritis, further prevention of arthritis’ attacks, as well as prevention of the formation and dissolution of existing crystals of sodium monourate. Asymptomatic drug-induced HU usually does not require medical correction. The decision to stop the inducer drug intake should be made after careful assessment of the benefit/risk ratio.
Keywords: interactions of pharmaceutical agents, safety of pharmacotherapy, drug-induced diseases, adverse drug reactions, gout, hyperuricemia
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About the Autors

Anton P. Pereverzev, PhD, associate professor of the Department of therapy and polymorbid pathology, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 125993, Moscow, 2/1 Barrikadnaya Str. E-mail: terapia_polimorbid@rmapo.ru. ORCID: 0000-0001-7168-3636. SPIN: 4842-3770
Olga D. Ostroumova, MD, professor, head of the Department of therapy and polymorbid pathology, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia, professor of the Department of clinical pharmacology and propedeutics of internal diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 125284, Moscow, 12/13 Polikarpova Str. E-mail: ostroumova.olga@mail.ru. ORCID: 0000-0002-0795-8225. SPIN: 3910-6585


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