Asymptomatic hyperuricemia - to treat or not to treat? - An evidence based review

• Autor(a) principal: Fernandes, Helena Maria Ribeiro
• Data de Publicação: 2017
• Outros Autores: Peixoto, Ana Catarina Andrade, Maia, Bruno Santos, Melo, Filipe Ribeiro, Miranda, Pedro Nuno Rego
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://rbmfc.org.br/rbmfc/article/view/1396
• topic: Hyperuricemia. Asymptomatic Condition. Uric Acid. Primary Health Care; Hiperuricemia. Enfermedades Asintomáticas. Ácido Úrico. Atención Primaria de Salud; Hiperuricemia. Doenças Assintomáticas Ácido Úrico. Atenção Primária à Saúde; Hiperuricemia

Introduction: Assessment of serum uric acid is frequently done in Primary Health Care, although not scientifically recommended. The subsequent therapeutic approach is often a clinical challenge, particularly in the case of asymptomatic hyperuricemia (AH). The aim of this study was to review the evidence on AH treatment. Methods: A research was conducted on Medline and evidence-based medical sites for articles published between April 2012 and April 2016 in English, Spanish or Portuguese using the keywords “hyperuricemia” and “asymptomatic conditions”. Results: Five articles met the inclusion criteria: one meta-analysis (MA), three systematic reviews (SR) and one original study (OS). MA and OS recommend treatment of AH, for the prevention of renal dysfunction and for the prevention of cardiovascular events (CV), respectively. Two SR do not recommend treatment of AH and one says that pharmacological treatment should be considered after an individual assessment of risk/benefit ratio, particularly in the prevention of gout in subjects with serum uric acid above 9 mg/dL. Conclusion: Very limited scientific data are available on the pharmacologic treatment of AH, with limitations and controversial results. The clinical significance of AH and its causal relationship with occurrence of acute attacks of gout, renal dysfunction and cardiovascular disease are still uncertain. There is no scientific evidence to support the pharmacological treatment of HA in asymptomatic patients (SOR B). Further studies, that are methodologically robust and oriented to the patient are needed.