Effect of fenofibrate on uric acid level in patients with gout

Abstract

Gout is a chronic disease associated with deposition of monosodium urate crystals and accompanied by diabetes, hypertension, and dyslipidemia. Hypertriglyceridemia is common among patients with gout, and fenofibrate is usually used to reduce triglyceride levels. The aim of this study is to determine the effect of uric acid reduction by fenofibrate in patients with gout administered uric acid lowering agents (viz., the xanthine oxidase inhibitors allopurinol and febuxostat). Data from 863 patients with gout were collected from electronic medical records comprising information on underlying diseases, laboratory findings, and drug histories. Among all the patients, 70 (8.11%) took fenofibrate with allopurinol or febuxostat. Male and young patients took fenofibrate more frequently, and hypertension was less frequent in patients administered xanthine oxidase inhibitors and fenofibrate than in those administered only xanthine oxidase inhibitors. After the treatment, serum uric acid levels more significantly decreased (−1.81 ± 2.41 vs. −2.40 ± 2.28 mg/dL, p = 0.043) in patients with fenofibrate cotreatment, than in those administered allopurinol or febuxostat alone. The effect of uric acid reduction was larger (b = −1.098, p < 0.001) in patients taking glucocorticoids than in those administered other treatments. There was no difference in the levels of creatinine, blood urea nitrogen, and aminotransferases between patients treated with and without fenofibrate. Fenofibrate additionally reduced uric acid levels without showing any change in the results of renal or liver function tests, suggesting that the addition of fenofibrate is a reasonable option for treating gout in patients having high triglyceride levels.

Association between dyslipidemia and serum uric acid levels in Korean adults: Korea National Health and Nutrition Examination Survey 2016-2017

“…Our comparison between dyslipidemia medication administered and non-administered subgroups showed that although not coherent in the category of two dyslipidemia components, a trend of lower serum uric acid levels in the medication administered group can be recognized. This result is in line with previous studies relating to statin and fenofibrate therapy to the decrease of serum uric acid levels [31][32][33].…”

Cell lineage-specific methylome and genome alterations in gout

“…Gout was associated with numerous comorbidities, including increased low-density lipoprotein levels, elevated triglyceride levels, and altered HbA 1c levels [ 2 , 3 ]. To confirm that the monocyte-specific differential methylation we observed was specific to gout, we also examined monocyte-specific associations with metabolic traits ( Supplementary Figure 1 , Step IIe; Supplementary Table 5 ).…”

“…Gout is the most common form of inflammatory arthritis worldwide, and its prevalence increases with age [ 1 ]. Gout is associated with numerous comorbidities, such as increased low-density lipoprotein levels, elevated triglyceride levels, and altered glycosylated hemoglobin (HbA 1c ) levels [ 2 , 3 ]. Despite increases in associated health and economic costs, gout remains a poorly controlled disease, and therapeutic choices are limited due to side effects or contraindications [ 4 ].…”

Fenofibrate decreased microalbuminuria in the type 2 diabetes patients with hypertriglyceridemia

“…Correlation analysis showed that the decrease in UACR was positively associated with the decrease in UA after fenofibrate treatment. Jung [24] et al study show that fenofibrate have an additionally role of reducing UA levels in patients having high TG levels. Several [25][26][27][28] studies have shown that fenofibrate can reduce UA levels in patients, especially in those patients with coexisting hyperlipidemia.…”