优化痛风治疗:当前和新出现的尿尿疗法的综合综述。

IF 3.8 3区 医学 Q1 RHEUMATOLOGY Joint Bone Spine Pub Date : 2024-11-30 DOI:10.1016/j.jbspin.2024.105826
Dan Kaufmann , Nathorn Chaiyakunapruk , Naomi Schlesinger
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引用次数: 0

摘要

痛风是最常见的炎症性关节炎,在美国大约有5.1%的成年人患有痛风。痛风是一种代谢性和自身炎症性疾病。尿酸池升高导致关节和其他组织内和周围尿酸钠(MSU)晶体的沉淀,以及随后的自身炎症反应。由于血清尿酸(SU)水平升高(高尿酸血症)与痛风严重程度相对应,因此降尿酸疗法(ult)是痛风治疗的基石。这些药物包括黄嘌呤氧化还原酶抑制剂、尿脲类药物(在美国不太常用,但在欧洲和亚洲广泛使用),包括苯溴马龙、多丁脲和probenecid(美国食品和药物管理局(FDA)唯一批准的尿脲类药物),以及尿酶,包括rasburicase和pegloticase(仅在美国可用)。肾脏滤过的每日尿酸负荷的90%以上通过肾转运蛋白被重新吸收。这些尿酸转运蛋白包括尿酸转运蛋白1 (URAT1)、葡萄糖转运蛋白9和有机阴离子转运蛋白1、3和4 (OAT1、OAT3、OAT4)。他们是已批准和正在进行的泌尿外科手术的目标。任何增加肾脏尿酸排泄的药物,不论其发挥作用的机制如何,都可被认为是促尿药物。本综述讨论了增加肾脏尿酸排泄的药物,无论是已批准的还是正在开发的,以及具有尿特性的标签外药物。
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Optimizing gout treatment: A comprehensive review of current and emerging uricosurics
Gout is the most common inflammatory arthritis, affecting approximately 5.1% of adults in the United States (US) population. Gout is a metabolic and autoinflammatory disease. Elevated uric acid pools lead to the precipitation of monosodium urate (MSU) crystals in and around joints, as well as other tissues, and the subsequent autoinflammatory response. Since elevated serum urate (SU) levels (hyperuricemia) correspond with gout severity, urate-lowering therapies (ULTs) are the cornerstone of gout treatment. ULTs include xanthine oxidoreductase inhibitors, uricosurics, less commonly used in the US but widely used in Europe and Asia, including benzbromarone, dotinurad, and probenecid (the only US Food and Drug Administration (FDA) approved uricosuric in the US), and uricases, including rasburicase and pegloticase (available only in the US). Over 90% of the daily load of uric acid filtered by the kidneys is reabsorbed through renal transporters. These urate transporters include uric acid transporter 1 (URAT1), glucose transporter 9, and organic anion transporters 1, 3, and 4 (OAT1, OAT3, OAT4). They are the target of approved and in-the-pipeline uricosurics. Any drug that increases renal excretion of uric acid, independently of the mechanism through which it exerts its effect, may be considered a uricosuric drug. This review discusses drugs that increase renal excretion of uric acid, either approved or in development, as well as off-label drugs with uricosuric properties.
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来源期刊
Joint Bone Spine
Joint Bone Spine 医学-风湿病学
CiteScore
4.50
自引率
11.90%
发文量
184
审稿时长
25 days
期刊介绍: Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.
期刊最新文献
Contents Editorial Board Associations of the ALDH2 rs671 polymorphism and alcohol intake with early-onset gout in a Chinese male cohort. Clinical and ultrasonographic predictors of disease activity after TNF-α inhibitor spacing in patients with psoriatic arthritis. Could the anti-modified protein antibody concept help better define seronegative rheumatoid arthritis?
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