Jiao Xue-Feng, Song Kunpeng, Jiao Xueyan, Li Hailong, Zeng Linan, Zou Kun, Zhang Wei, Wang Huiqing, Zhang Lingli
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2023 Jan 9;13:1045561. doi: 10.3389/fphar.2022.1045561. eCollection 2022.
The role of antihypertensive drugs in inducing hyperuricaemia and gout has been a long-term concern in clinical practice. However, clinical studies regarding this issue are limited in number and have yielded inconsistent results. We comprehensively evaluated the association between various antihypertensive drugs and the occurrences of hyperuricaemia, gout and related adverse events (AEs) using the FDA Adverse Event Reporting System (FAERS), aiming to guide the selection of antihypertensive drugs with a goal of minimizing the risk of hyperuricaemia, gout and related AEs. We used OpenVigil 2.1 to query the FAERS database. Hyperuricaemia, gout and related AEs were defined by 5 Preferred Terms: hyperuricaemia, gout, gouty arthritis, gouty tophus and urate nephropathy. Disproportionality analysis was performed, and a positive signal indicated an association between AEs and antihypertensive drugs. The numbers of antihypertensive drugs with positive signals for hyperuricaemia, gout, gouty arthritis, gouty tophus and urate nephropathy were 46, 66, 27, 8 and 6, respectively. These drugs included diuretics, antihypertensive drugs with central action, α blockers, β blockers, α and β blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, renin inhibitors, vasodilators, and compound preparations. Furthermore, 42 antihypertensive drugs had positive signal for more than one AEs. Our study suggests that some potassium-sparing diuretics, calcium channel blockers and losartan may be associated with increased risk of hyperuricaemia, gout or related AEs, which is inconsistent with most previous studies. Moreover, Our study also suggests that some antihypertensive drugs with central action, α and β blockers, renin inhibitors and vasodilators may be associated with increased risk of hyperuricaemia, gout or related AEs, which has not been reported in previous studies. These findings complement real-world evidence on the potential risks of hyperuricaemia, gout and related AEs associated with antihypertensive drugs.
抗高血压药物在诱发高尿酸血症和痛风方面的作用一直是临床实践中长期关注的问题。然而,关于这个问题的临床研究数量有限,且结果并不一致。我们使用美国食品药品监督管理局不良事件报告系统(FAERS)全面评估了各种抗高血压药物与高尿酸血症、痛风及相关不良事件(AE)发生之间的关联,旨在指导抗高血压药物的选择,以尽量降低高尿酸血症、痛风及相关AE的风险。我们使用OpenVigil 2.1查询FAERS数据库。高尿酸血症、痛风及相关AE由5个首选术语定义:高尿酸血症、痛风、痛风性关节炎、痛风石和尿酸盐肾病。进行了不成比例分析,阳性信号表明AE与抗高血压药物之间存在关联。高尿酸血症、痛风、痛风性关节炎、痛风石和尿酸盐肾病呈阳性信号的抗高血压药物数量分别为46、66、27、8和6种。这些药物包括利尿剂、具有中枢作用的抗高血压药物、α受体阻滞剂、β受体阻滞剂、α和β受体阻滞剂、钙通道阻滞剂、血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂、肾素抑制剂、血管扩张剂和复方制剂。此外,42种抗高血压药物在不止一种AE上呈阳性信号。我们的研究表明,一些保钾利尿剂、钙通道阻滞剂和氯沙坦可能与高尿酸血症、痛风或相关AE风险增加有关,这与大多数先前的研究不一致。此外,我们的研究还表明,一些具有中枢作用的抗高血压药物、α和β受体阻滞剂、肾素抑制剂和血管扩张剂可能与高尿酸血症、痛风或相关AE风险增加有关,这在先前的研究中尚未报道。这些发现补充了关于抗高血压药物相关高尿酸血症、痛风及相关AE潜在风险的真实世界证据。