An Up-to-date Systematic Review on Real-world Evidence for the Management of Asymptomatic Hyperuricemia

The prevalence of hyperuricemia is increasing worldwide. The emergent concerns have provoked investigations into the management of AUH. While there are existing reviews discussing the pharmacological treatment of AUH based on randomized controlled trials, an updated review specifically focusing on the safety and effectiveness of pharmacological interventions in real-world settings for AUH is currently lacking. For that reason, the objective of this review was to provide a comprehensive summary of the existing evidence extracted from the available research studies that focused on the safety and effectiveness of the adopted medical treatment approaches for AUH in real-world settings. Based on the analysis verdicts, benzbromarone appeared to be the most effective urate-lowering therapy (ULT) in achieving the desired serum uric acid (sUA) levels and in lowering the incidence of initial gout flares. Febuxostat also demonstrated valuable effectiveness in our analysis. On the other hand, based on the safety of the popular allopurinol medication, one real-world study identified skin-related adverse effects associated with it. However, it is important to note that the studies included in the analysis were predominantly conducted in Japan and Taiwan, which limits the generalizability of these findings. To enhance the applicability of the review outcomes, future global studies should cover a wider assortment of populations from various countries and regions.