Reduced Incidence of Stroke in Patients with Gout Using Benzbromarone

Niu, Sheng‐Wen; Hung, Chi‐Chih; Lin, Hugo You-Hsien; Kuo, I‐Ching; Huang, Jiun-Chi; He, Jiun-Shiuan; Wen, Zhi‐Hong; Liang, Peir‐In; Chiu, Yi‐Wen; Chang, Jer‐Ming; Hwang, Shang‐Jyh

doi:10.3390/jpm12010028

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…Probenecid and Benzpromarone act through inhibition of URAT1 and GLUT9. Recently, it was shown that the use of Benzpromarone can be associated with a lower risk of stroke in patients diagnosed with gout [ 87 ]. It should be mentioned that Benzpromarone is considered one of the four drugs linked to severe hepatotoxicity, and for this reason, it was withdrawn in the USA [ 88 ].…”

Section: Available Treatment Option For Lowering Uric Acidmentioning

confidence: 99%

Uric Acid and Oxidative Stress—Relationship with Cardiovascular, Metabolic, and Renal Impairment

Gherghina

Peride

Ţigliş

et al. 2022

IJMS

136

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Background: The connection between uric acid (UA) and renal impairment is well known due to the urate capacity to precipitate within the tubules or extra-renal system. Emerging studies allege a new hypothesis concerning UA and renal impairment involving a pro-inflammatory status, endothelial dysfunction, and excessive activation of renin–angiotensin–aldosterone system (RAAS). Additionally, hyperuricemia associated with oxidative stress is incriminated in DNA damage, oxidations, inflammatory cytokine production, and even cell apoptosis. There is also increasing evidence regarding the association of hyperuricemia with chronic kidney disease (CKD), cardiovascular disease, and metabolic syndrome or diabetes mellitus. Conclusions: Important aspects need to be clarified regarding hyperuricemia predisposition to oxidative stress and its effects in order to initiate the proper treatment to determine the optimal maintenance of UA level, improving patients’ long-term prognosis and their quality of life.

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Section: Available Treatment Option For Lowering Uric Acidmentioning

confidence: 99%

Uric Acid and Oxidative Stress—Relationship with Cardiovascular, Metabolic, and Renal Impairment

Gherghina

Peride

Ţigliş

et al. 2022

IJMS

136

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“…The reason for lower ischemic and hemorrhagic stroke incidence in the gout cohort in the first 3 years was unclear. Because the definition of gout in our study requires the use of a urate-lowering agent at enrolment, a previous study showed urate-lowering agents might reduce the incidence of stroke in gout patients [40]. Thus, the temporal lower incidence of stroke in the first 3 years may be because of the interference of urate-lowering agents.…”

Section: Discussionmentioning

confidence: 94%

Stroke Risk in Patients with Gout: A Nationwide Retrospective Cohort Study in Taiwan

Tsai

Kuo

See

et al. 2022

JCM

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Objectives: To estimate stroke risk in Taiwanese patients with gout. Methods: We enrolled patients from the Taiwan National Health Insurance Database, with gout diagnosed from 2000 to 2008, and followed them up until December 2018. This cohort was propensity score-matched according to birth year, sex, the date of diagnosis of gout, comorbidities, and co-medications with individuals without gout (controls) (n = 310,820 in each group). Stroke was defined as the primary diagnosis at discharge after the index date. To evaluate ischemic and hemorrhagic stroke risks, we calculated their incidence, hazard ratio (HR), and two-year moving average incidence rate. Results: The incidence (95% CI) and HR of ischemic stroke were lower in the gout group than in the control group in the first 3 years (incidence: 4.74 [4.60–4.88] vs. 5.17 [5.03–5.32] per 1000 person-years; HR: 0.92 [0.88–0.96]), then became significantly higher than in the control group after 3 years (incidence: 4.10 [4.04–4.16] vs. 3.81 [3.75–3.87] per 1000 person-years; HR: 1.08 [1.05–1.10]). Similarly, the incidence (95% CI) and HR of hemorrhagic stroke was lower in the gout group than in the control group in the first 3 years (incidence: 1.51 [1.43–1.59] vs. 1.70 [1.62–1.79] per 1000 person-years; HR: 0.88 [0.82–0.92]), then became significantly higher than in controls after 3 years (incidence: 1.43 [1.39–1.46] vs. 1.26 [1.22–1.29] per 1000 person-years; HR: 1.14 [1.10–1.18]). Conclusions: In Taiwan, patients with gout had higher risks of ischemic and hemorrhagic stroke after 3 years.

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“…168 Apart from that, benzbromarone significantly decreased the incidence of stroke and diabetes in gout patients aged 40 and above. 169,170 Even so, benzbromarone was never approved in the United States, and its withdrawal from the European market in 2003 was due to its adverse effects such as liver dysfunction and fulminant hepatitis. 171 PEGylated Recombinant Uricase.…”

Section: Urate-lowering Therapy (Ult)mentioning

confidence: 99%

“…Enomoto et al conducted a study on different uricosuric agents and reported that benzbromarone potently reduced urate reabsorption by 93% . Apart from that, benzbromarone significantly decreased the incidence of stroke and diabetes in gout patients aged 40 and above. , Even so, benzbromarone was never approved in the United States, and its withdrawal from the European market in 2003 was due to its adverse effects such as liver dysfunction and fulminant hepatitis …”

Section: Treatment Strategies For Goutmentioning

confidence: 99%

Gout Management Using Nanocarrier Systems: A Review

Qi,

Mohd Nordin,

Mahmood

et al. 2024

ACS Appl. Nano Mater.

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Gout is an inflammatory arthropathy resulting from the deposition of monosodium urate crystals in and around joints, triggering the release of pro-inflammatory cytokines. Some of the key principles for managing gout are encompassing comorbidity screening, gout flare treatment, urate-lowering therapy, and antiinflammatory prophylaxis. One of the major concerns with gout treatment is the side effects of drug due to uncontrolled biodistribution. Nanocarrier systems are utilized to surmount the limitations of current drugs, including not only biodistribution issues but also the stability and bioavailability of the drugs. Nanocarriers as promising drug delivery systems can effectively deliver drugs by specifically targeting inflamed tissues through enhanced permeability and retention effect mediated delivery. Notable examples include liposomes, niosomes, ethosomes, transfersomes, solid lipid nanoparticles, polymeric nanoparticles, nanoemulsions, and liquid crystalline nanoparticles, namely, cubosomes, hexosomes, and spongosomes. These nanocarriers hold great promise as vehicles for transporting poorly therapeutic agents to precise target sites, associated with controlled release capabilities to bolster bioavailability. Preclinical studies have demonstrated the efficacy of nanocarrier-based therapies in reducing inflammation by specifically targeting inflamed tissues, inhibiting urate crystal formation, and improving joint function in animal models of gout. In this review, we explore the main nanocarrier systems, including their respective advantages and drawbacks, and emphasize their role in nanoformulations for advancing gout treatment. The encapsulation of active agents within nanocarriers for gout therapy represents a significant advancement in the pharmaceutical area and nanomedicine application to succeed in the overall context of gout treatment in the near future.

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Reduced Incidence of Stroke in Patients with Gout Using Benzbromarone

Cited by 7 publications

References 36 publications

Uric Acid and Oxidative Stress—Relationship with Cardiovascular, Metabolic, and Renal Impairment

Uric Acid and Oxidative Stress—Relationship with Cardiovascular, Metabolic, and Renal Impairment

Stroke Risk in Patients with Gout: A Nationwide Retrospective Cohort Study in Taiwan

Gout Management Using Nanocarrier Systems: A Review

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