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

Authors

  • Helena Maria Ribeiro Fernandes Unidade de Saúde Familiar do Mar, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal
  • Ana Catarina Andrade Peixoto Unidade de Saúde Familiar do Mar, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal
  • Bruno Santos Maia Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal
  • Filipe Ribeiro Melo Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal
  • Pedro Nuno Rego Miranda Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

DOI:

https://doi.org/10.5712/rbmfc12(39)1396

Keywords:

Hyperuricemia. Asymptomatic Condition. Uric Acid. Primary Health Care

Abstract

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.

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Author Biographies

Helena Maria Ribeiro Fernandes, Unidade de Saúde Familiar do Mar, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

Interna de Formação Específica em Medicina Geral e Familiar

Ana Catarina Andrade Peixoto, Unidade de Saúde Familiar do Mar, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

Interna de Formação Específica em Medicina Geral e Familiar

Bruno Santos Maia, Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

Interno de Formação Específica em Medicina Geral e Familiar

Filipe Ribeiro Melo, Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

Interno de Formação Específica em Medicina Geral e Familiar

Pedro Nuno Rego Miranda, Unidade de Saúde Familiar Eça de Queirós, Agrupamento dos Centros de Saúde Grande Porto IV, Póvoa de Varzim/Vila do Conde, Portugal

Interno de Formação Específica em Medicina Geral e Familiar

References

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Published

2017-03-01

How to Cite

1.
Fernandes HMR, Peixoto ACA, Maia BS, Melo FR, Miranda PNR. Asymptomatic hyperuricemia - to treat or not to treat? - An evidence based review. Rev Bras Med Fam Comunidade [Internet]. 2017 Mar. 1 [cited 2024 Jul. 22];12(39):1-6. Available from: https://rbmfc.org.br/rbmfc/article/view/1396

Issue

Vol. 12 No. 39 (2017): Janeiro-dezembro

Section

Research Articles

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By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.

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