Objective: Four clinical studies of dotinurad in patients with hyperuricemia with or without gout conducted in Japan were pooled to evaluate the relationship between the cumulative number of cardiovascular risk factors (obesity, hypertension, dyslipidemia, and impaired glucose tolerance) and the uric acid-lowering effect of dotinurad.
Methods: The full analysis set populations in each study were pooled, of which 421 and 59 patients were administered dotinurad and the placebo, respectively. Dotinurad was evaluated at doses of 0.5, 1, 2, and 4 mg in these studies. Endpoints were the rate of decrease in serum uric acid levels and the rate of achievement of serum uric acid levels ≤ 6.0 mg/dL with the cumulative number of cardiovascular risk factors.
Results: Dotinurad showed serum uric acid-lowering effect in hyperuricemic patients with multiple cardiovascular risk factors. Administering 2 mg dotinurad exhibited a lower rate of achieving serum uric acid levels ≤ 6.0 mg/dL in patients with more cardiovascular risk factors than in those with fewer cardiovascular risk factors. However, serum uric acid levels ≤ 6.0 mg/dL were achieved in almost all patients treated with 4 mg dotinurad regardless of the cumulative number of cardiovascular risk factors.
Conclusion: Dotinurad lowered serum uric acid levels in hyperuricemic patients with multiple cardiovascular risk factors. Adjusting the dose of dotinurad while taking into consideration the patient's background of multiple cardiovascular risk factors may be a new therapeutic strategy to control serum uric acid levels.
Objective: To investigate the frequency and findings of monosodium urate (MSU) deposition in gout flares compared to those in asymptomatic hyperuricemia.
Methods: A total of 109 consecutive patients with gout or asymptomatic hyperuricemia who visited our clinic between 2017 and 2020 were enrolled in this study. The inflamed joints of patients with gout and one of the two metatarsophalangeal joints of patients with asymptomatic hyperuricemia were examined for MSU deposition on ultrasonography. We investigated whether imaging findings were related to the history of gout flares and comorbidities of the patients.
Results: A total of 52 patients were eligible for this study. The patients with gout were older than the asymptomatic patients. All patients with gout showed the double contour sign and a hyperechoic aggregate representing MSU deposition, whereas three of the 15 patients with asymptomatic hyperuricemia had any of these ultrasonography signs. There was no relationship between comorbidities and gout flares.
Conclusions: The presence of MSU deposition on ultrasonography indicated a history of gout flare, and it rarely occurred in patients with asymptomatic hyperuricemia.