Overview of Serum Uric Acid Treatment Targets in Gout: Why Less Than 6 mg/dL?

Ruoff, Gary; Edwards, N. Lawrence

doi:10.1080/00325481.2016.1221732

Cited by 50 publications

(45 citation statements)

References 77 publications

(156 reference statements)

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“…In young patients, hyperuricemia stimulates oxidative stress, inflammation, and inflammatory response as feedback from the oxidative stress triggered by the high uric acid concentration itself [3]. Acute and chronic inflammation due to crystal deposition in joints and soft tissues is a consequence that occurs when hyperuricemia is not immediately treated [4].…”

Section: Introductionmentioning

confidence: 99%

Xanthine Oxidase Inhibitory Activity of Methanol Extract Fractions of Various Indonesian Ethnopharmacological Plants

Sakti¹,

Widyastanto²,

Maulidina³

et al. 2020

Int J App Pharm

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Objective: Hyperuricemia involves an increase in serum uric acid levels, resulting in kidney damage, increased mortality, and reduced quality of life.Inhibitors of xanthine oxidase, which catalyzes the last step in uric acid synthesis, are targets for therapeutic intervention.Methods: An ethnopharmacological approach, screening four native Indonesian herbal medicinal plants with reported activity against hyperuricemia,was used for preliminary studies, fractionating methanolic extracts by solvent partitioning. Fractions were then tested in vitro for xanthine oxidaseinhibitory activity, and the most active fraction was then subjected to preliminary phytochemical screening.Results: The target tissue of the four herbal medicinal plants investigated was Indian bay leaf (Syzygium polyanthum Wight.), God’s crown fruit(Phaleria macrocarpa Boerl.), snake fruit peel (Salacca edulis Reinw.), and Job’s tears tuber (Cyperus rotundus Linn.). Each sample was extracted bymaceration with 80% methanol. The concentrated extract was then fractionated by the liquid-liquid partition method (1:1 v/v) using n-hexane, ethylacetate, butanol, and methanol sequentially as solvents. The results revealed that the ethyl acetate fraction was the most active fraction. S. polyanthumleaf and C. rotundus tuber showed the greatest potential in inhibiting xanthine oxidase, with half-maximal inhibitory concentrations of 18.43 and10.50 μg/ml, respectively. Enzyme kinetics analysis shows that each plant fraction works as a competitive inhibitor of xanthine oxidase.Conclusion: Preliminary screening identified the ethyl acetate fractions of two native Indonesian herbal medicinal plants as showing potential foranti-hyperuricemia activity.

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Section: Introductionmentioning

confidence: 99%

Xanthine Oxidase Inhibitory Activity of Methanol Extract Fractions of Various Indonesian Ethnopharmacological Plants

Sakti¹,

Widyastanto²,

Maulidina³

et al. 2020

Int J App Pharm

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“…The fact that there is a significant increase in the onset of newly diagnosed hypertension, metabolic syndrome in healthy patients with elevated levels of sUA, its role has been proved to be an independent risk factor in CV patients. Therefore, all considerations presented, point to the need for greater attention to monitoring sUA levels when diagnosing patients, not only from a rheumatological standpoint but also regarding CV and renal risk, including eGFR measurements [4,195]. This will play a key role in the prevention of CVD and improve future treatment strategies.…”

Section: Most Relevant Recommendationsmentioning

confidence: 99%

Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk

Borghi¹,

Tykarski²,

Widecka³

et al. 2018

Cardiol J

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“…Substantial evidence suggests that serum uric acid (sUA), as the end product of purine metabolism, is an independent biomarker capable of predicting morbidity and mortality in patients with a variety of cardiovascular diseases (CVD) [14], as well as in healthy young and middle-aged adults [15]. e 2018 expert consensus for the diagnosis and treatment of the patient with hyperuricemia [16] highlights the importance of monitoring sUA levels in patients with hyperuricemia and high CV risk [14,17].…”

Section: Introductionmentioning

confidence: 99%

Hyperuricemia is a Risk Factor for One-Year Overall Survival in Elderly Female Patients with Acute Coronary Syndrome

Tai

Zhu

et al. 2020

Cardiovascular Therapeutics

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Background. Hyperuricemia is a risk factor for cardiovascular diseases, but the impact of hyperuricemia and sex-related disparities is not fully clear in elderly patients with acute coronary syndrome (ACS). Objective. To investigate the association between hyperuricemia and 1-year all-cause mortality in elderly patients with ACS. Methods. This retrospective cohort study included 711 consecutive ACS patients aged ≥75 years, hospitalized in our center between January 2013 and December 2017. Serum uric acid (sUA), in-hospital events, and 1-year follow-up were analyzed. Multivariable logistic regression models were used to explore the risk factors for in-hospital events and 1-year all-cause mortality. Results. sUA levels were higher in males than in females (381.4 ± 110.1 vs. 349.3 ± 119.1 μmol/l, P<0.001). Prevalence of hypertension (80.5% vs. 72.6%, P=0.020), atrial fibrillation (16.2% vs. 9.5%, P=0.008), and severe heart failure (61.0% vs. 44.2%, P<0.001) were higher in patients with hyperuricemia than in patients with normal sUA. During the 1-year follow-up, 135 patients died (19.0%); all-cause mortality was higher in patients with hyperuricemia than in patients with normal sUA (23.1% vs. 16.7%, P=0.039). Hyperuricemia is related to in-hospital ventricular tachycardia and 1-year all-cause mortality (OR = 1.799, 95% CI 1.050–3.081, P=0.033; OR = 1.512, 95% CI 1.028–2.225, P=0.036, respectively). Multivariable regression analysis models showed that hyperuricemia was an independent risk factor of 1-year all-cause mortality in women (OR = 2.539, 95% CI 1.001–6.453, P=0.050), but not in men (OR = 0.931, 95% CI 0.466–1.858, P=0.839) after adjustment for confounding variables. Conclusions. Hyperuricemia is an independent risk factor for 1-year all-cause mortality in elderly female patients with ACS.

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Overview of Serum Uric Acid Treatment Targets in Gout: Why Less Than 6 mg/dL?

Cited by 50 publications

References 77 publications

Xanthine Oxidase Inhibitory Activity of Methanol Extract Fractions of Various Indonesian Ethnopharmacological Plants

Xanthine Oxidase Inhibitory Activity of Methanol Extract Fractions of Various Indonesian Ethnopharmacological Plants

Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk

Hyperuricemia is a Risk Factor for One-Year Overall Survival in Elderly Female Patients with Acute Coronary Syndrome

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