Study of the effectiveness of urate-lowering therapy in patients with gout and metabolic syndrome
Summary. Hyperuricemia is an important component of metabolic syndrome and an independent risk factor for the development of cardiovascular diseases, arterial hypertension, type 2 diabetes mellitus and nephrolithiasis. The aim of the study was to evaluate the effectiveness of urate-lowering therapy with febuxostat in patients with gout and metabolic syndrome. The study included 85 patients (73 men, 12 women) aged 47–57 years with a confirmed diagnosis of gout and metabolic syndrome. Patients received febuxostat at a mean dose of 76.5 mg/day for 6 months. The results showed a significant decrease in uric acid levels by almost half (from 523 to 326 μmol/L, p<0.001). There was also a statistically significant decrease in systolic (from 140 to 130 mmHg) and diastolic blood pressure (from 90 to 80 mmHg) without changing antihypertensive therapy (p<0.001). In addition, an improvement in the lipid profile was observed — a decrease in total cholesterol, LDL and VLDL (p<0.05). A trend towards a decrease in fasting blood glucose was also observed, although glycated hemoglobin levels were not statistically different. A small subset of patients (n=10) experienced weight loss without additional dietary recommendations. These data support the efficacy of febuxostat as a urate-lowering agent in gout in the metabolic syndrome, with improvements in cardiometabolic parameters. Further studies are needed to investigate the mechanisms of action and potential additional effects of urate-lowering therapy.
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