Management of asymptomatic hyperuricemia: Integrated Diabetes &amp; Endocrine Academy (IDEA) consensus statement

Valsaraj, Rahul; Singh, Awadhesh Kumar; Gangopadhyay, Kalyan Kumar; Ghoshdastidar, Biswajit; Goyal, Ghanshyam; Batin, Masood; Mukherjee, Dibyendu; Sengupta, Upal; Chatterjee, Subhajit; Sengupta, Nilanjan

doi:10.1016/j.dsx.2020.01.007

Cited by 29 publications

(17 citation statements)

References 79 publications

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“…Hyperuricemia is a metabolic disease caused by disorders in purine metabolism or reduced uric acid excretion and develops into gout with prolonged elevation of serum urate (1). Hyperuricemia is "traditional risk factor" for cardiovascular diseases with hyperlipidemia, hypertension, and diabetes (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis

Zhang

Shi

et al. 2021

Front. Med.

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Background: Hyperuricemia is a common metabolic disease and has become a public health problem because of its increasing prevalence and association with comorbidities. Allopurinol and febuxostat are recommended as the first-line treatments for hyperuricemia and gout. But cardiovascular safety between febuxostat and allopurinol is still controversial. The purpose of this study is to compare the cardiovascular safety of XOIs and placebo in hyperuricemic patients with or without gout.Methods: PubMed, Embase via OVID, Cochrane Library, CNKI, Wanfang, and VIP were searched from their earliest records to February 8th 2021. ClinicalTrials.gov was also searched for unpublished data. The reference lists of included studies and relevant review articles investigating the cardiovascular safety of XOIs in hyperuricemia patients are screened for potentially eligible studies. Randomized controlled trials (RCTs) evaluating allopurinol (100~900 mg/d), febuxostat (20~120 mg/d), or placebo for hyperuricemia were included. The outcomes were incidence of MACE, non-fatal MI, non-fatal stroke, and cardiovascular death. We conducted a Bayesian random-effects network meta-analysis on the included randomized controlled trials using the Markov Chain Monte Carlo simulation method. The grading of recommendations assessment, development, and evaluation (GRADE) approach was used to assesses the certainty of the evidence.Results: Ten RCTs with 18,004 participants were included. The network estimates showed that there was no significant difference observed among febuxostat, allopurinol, and placebo regarding outcomes. The certainty of the evidence ranged from very low to moderate. The probabilities of rankings and SUCRA showed that compared to placebo, febuxostat, and allopurinol might prevent adverse cardiovascular events.Conclusion: Febuxostat is not associated with increasing risk of adverse cardiovascular events compared to allopurinol; and compared to placebo, whether febuxostat and allopurinol reduce the risk of adverse cardiovascular events remains uncertain.

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Section: Introductionmentioning

confidence: 99%

Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis

Zhang

Shi

et al. 2021

Front. Med.

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“…По мере увеличения концентрации уратов в крови увеличивается образование кристаллов МК, что приводит к их отложению в суставах, сухожилиях и других тканях, а также в почках, с образованием камней [199]. ГУ развивается в результате повышенной выработки МК, снижения ее выведения почками или в результате комбинации этих нарушений [199,200]. Уровень МК зависит от расы/этнической принадлежности, пола, возраста, что относится к немодифицируемым ФР [201][202][203].…”

Section: гиперурикемияunclassified

“…Часто используемые препараты (петлевые и тиазидные диуретики; противотуберкулезные препараты: пиразинамид и этамбутол; аспирин в низких дозах (≤325 мг/сут. ); иммунодепрессанты: циклоспорин, такролимус; леводопа; никотиновая кислота), снижающие почечную экскрецию уратов, могут привести к повышению МК [40,197,199,200,204].…”

Section: гиперурикемияunclassified

Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines

Драпкина¹,

Карамнова²,

Концевая³

et al. 2021

Cardiovasc Ther Prev

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The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.

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“…Если принять 4,0 ммоль/л в качестве уровня калия, ниже которого снижение не желательно, то при исходном уровне калия не ниже 4,4 ммоль/л назначение любого из диуретиков представляется метаболически безопасным. В соответствии с последними европейскими рекомендациями [12] целевой уровень мочевой кислоты при лечении бессимптомной гиперурикемии должен быть <357 ммоль/л. Используя тот же подход, что и при оценке безопасного уровня калия при назначении диуретиков, таким уровнем для мочевой кислоты является уровень <290 мкмоль/л.…”

Section: метаанализы применения диуретиков при агunclassified

Diuretics for hypertension from the perspective of novel clinical guidelines and meta-analyzes

Недогода¹

2021

Russ J Cardiol

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A review of the efficacy and safety of diuretics in hypertension was carried out from the standpoint of current clinical guidelines. Also, updated data from metaanalyzes of the efficacy and metabolic effects of diuretic therapy were reviewed. Currently, a more differentiated approach to the appointment of a specific diuretic as part of antihypertensive therapy, taking into account the effect on endpoints and metabolic effects, seems relevant.

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Management of asymptomatic hyperuricemia: Integrated Diabetes & Endocrine Academy (IDEA) consensus statement

Cited by 29 publications

References 79 publications

Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis

Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis

Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines

Diuretics for hypertension from the perspective of novel clinical guidelines and meta-analyzes

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