Effects of combination treatment using anti-hyperuricaemic agents with fenofibrate and/or losartan on uric acid metabolism

Abstract

Objective: To assess the effect of a combination treatment using anti-hyperuricaemic agents with fenofibrate and/or losartan on uric acid metabolism in hypertriglyceridaemic and/or hypertensive patients with gout.

Methods: Twenty seven patients with gout were included in a fenofibrate plus anti-hyperuricaemic agents combination study, and 25 in a losartan plus anti-hyperuricaemic agents combination study. Serum uric acid concentration, uric acid clearance, and 24 hour urinary uric acid excretion were measured before and two months after the addition of fenofibrate (300 mg once daily) or losartan (50 mg once daily) to anti-hyperuricaemic agents.

Results: Combination therapy of fenofibrate or losartan with anti-hyperuricaemic agents, which included benzbromarone (50 mg once daily) or allopurinol (200 mg twice a day), significantly reduced serum uric acid concentrations in accordance with increased uric acid excretion.

Conclusion: A combination of fenofibrate or losartan with anti-hyperuricaemic agents is a good option for the treatment of gout patients with hypertriglyceridaemia and/or hypertension, though the additional hypouricaemic effect may be modest.

Figure 1

Changes in uric acid metabolism at baseline (before) and after the addition of fenofibrate. (A, B, C) 1, baseline; 2, benzbromarone; 3, benzbromarone + fenofibrate. (D, E, F) 1, baseline; 2, allopurinol; 3, allopurinol + fenofibrate.

Figure 2

Changes in uric acid metabolism at baseline (before) and after the addition of losartan. (A, B, C) 1, baseline; 2, benzbromarone; 3, benzbromarone + losartan. (D, E, F) 1, baseline; 2, allopurinol; 3, allopurinol + losartan.