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Abstract: PO1812

Potential Benefits of Asymptomatic Hyperuricemia Treatment: A Systematic Review and Meta-Analysis of Randomized Control Trials

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Gala, Dhir N., American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten (Dutch part)
  • Said, Kirellos Said Abbas, Alexandria University Faculty of Medicine, Alexandria, Egypt
  • El-Shahat, Nahla Ahmed, Al-Azhar University Faculty of Medicine, Cairo, Egypt
  • Parrill, Allison, American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten (Dutch part)
  • Mohamed, Hadeir Said, Al-Azhar University Faculty of Medicine, Cairo, Egypt
  • Abdelhalim, Nada, Istanbul Gelisim Universitesi, Istanbul, Istanbul, Turkey
  • Amin, Mostafa Atef, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
  • Abdalshafy, Hassan Sayed, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
  • Alahmar, Majd, Mansoura University Faculty of Medicine, Mansoura, Egypt
  • Huy, Nguyen Tien, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
  • Abdel Gawad, Mohammed, Gawad Nephrology Clinic, Alexandria, Egypt
Background

Asymptomatic hyperuricemia is strongly associated with an increased risk for chronic kidney disease and cardiovascular conditions. However, many current guidelines suggest no medical treatment for patients with asymptomatic hyperuricemia. We aim to systematically analyze randomized control trials with serum uric acid-lowering medication in the treatment of patients with asymptomatic hyperuricemia.

Methods

A literature review of seven medical databases (Scopus, Clinical Gov, Pubmed, Web of Science, Google Scholar, VHL, and GHL) for randomized controlled trials related to the treatment of asymptomatic hyperuricemia was conducted. Bias was evaluated using the Cochrane Risk of Bias 2 tool. Standard differences of means of variables of interest were combined across studies to compare the effects of uric acid lowering treatment versus control. Using the Comprehensive Meta-Analysis program, fixed-effects and random heterogeneity model, forest plots were created for each variable of interest.

Results

Analysis of eleven studies showed significant decreases in creatinine [-0.302 (95% CI: -0.599, -0.005)], systolic blood pressure [-0.277 (95% CI: -0.5, -0.055)], and serum uric acid [-1.972 (95% CI: -2.145, -1.800)] in the treatment versus control group. Furthermore, significant increases in estimated glomerular filtration rate (eGFR) after sensitivity analysis [0.228 (95% CI: 0.027, 0.428)], and high-sensitivity C-reactive protein [0.588 (95% CI: 0.205, 0.971)] were observed in the treatment versus control group. Lastly, non-significant decreases in carotid intima-media thickness test [-0.113 (95% CI: -0.269, 0.042)], and diastolic blood pressure [-0.312 (95% CI: -0.638, 0.013)], while non-significant increases in hemoglobin A1C [0.394 (95% CI: -0.026, 0.813)] and fasting glucose level [0.117 (95% CI: -0.145, 0.380)] were found in the treatment versus control group.

Conclusion

This study showed that uric acid lowering treatment of patients with asymptomatic hyperuricemia may be beneficial in those with elevated creatinine and blood pressure, and decreased eGFR.