Abstract

BENTO, Joana Rita Sousa et al. Treatment of asymptomatic hyperuricemia: an evidence-based review. Rev Port Med Geral Fam [online]. 2019, vol.35, n.6, pp.469-480. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i6.12308.

Aim: To analyze the most recent evidence regarding the pharmacological treatment of asymptomatic hyperuricemia. Data sources: PubMed, The Cochrane Library, National Guideline Clearinghouse, Canadian Medical Association, Evidence-based Medicine and NICE Evidence Search. Methods: Clinical guidelines, randomized controlled trials, meta-analysis and systematic reviews published in the last five years in Portuguese and English were searched. MeSH terms: ‘hyperuricemia/therapy’ e ‘asymptomatic disease’. Inclusion criteria: articles where pharmacological treatment was evaluated in the asymptomatic hyperuricemic patient, with or without comorbidities. Main outcome: prevention of gouty arthritis, prevention, and benefit of renal disease, and cardiovascular events, the cut-off for therapeutic initiation and target value to be achieved. The Strength of Recommendation Taxonomy of the American Academy of Family Physicians was used to assess the levels of evidence and assignment of recommendation strength. Results: The electronic search retrieved 360 articles. After screening, ten articles were included: four clinical guidelines, five randomized controlled trials, and one meta-analysis. Overall, the clinical trials demonstrate the beneficial use of hypouricemic therapy in cardiovascular risk factors, as well as markers of chronic renal disease, also verified in the meta-analysis, regarding chronic kidney disease. On the other hand, clinical guidelines endorse that there is no evidence to recommend the pharmacological treatment of asymptomatic hyperuricemia. Conclusion: Although recent studies show the benefit of the asymptomatic hyperuricemia treatment in patients with comorbidities, such as in kidney disease, these studies have methodological limitations. The authors conclude that there is no current scientific evidence supporting the pharmacological treatment of hyperuricemia in asymptomatic patients (SORT B).

Keywords : Hyperuricemia/therapy; Asymptomatic disease.

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