Clinical analysis and risk management of drug-induced hyperuricemia

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Author: Xiao-Lei REN ¹ Yi-Qiu ZHAN ¹ Chun-Yan ZHANG ¹  Lin HUANG ¹  Yu-Fei FENG ²

Affiliation: 1. Department of Pharmacy, Peking University People's Hospital, Beijing 100044, China 2. Clinical Trial Site, Peking University People's Hospital, Beijing 100044, China

Keywords: Hyperuricemia Drug-induced Drug safety Risk management

DOI: 10.19960/j.issn.1005-0698.202309002

Reference: Xiao-Lei REN, Yi-Qiu ZHAN, Chun-Yan ZHANG, Lin HUANG, Yu-Fei FENG.Clinical analysis and risk management of drug-induced hyperuricemia[J].Yaowu Liuxingbingxue Zazhi,2023, 32(9):969-974.DOI: 10.19960/j.issn.1005-0698.202309002.[Article in Chinese]  Copied

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Abstract

Objective To discuss the occurrence characteristics of drug-induced hyperuricemia based on clinical examples, and to provide evidence for clinical drug safety and risk management.

Methods Case reports of drug-induced hyperuricemia publicly published in medical journals from inception to December 31, 2022 were retrieved, and adverse drug reaction (ADR) reports of drug-induced hyperuricemia reported in our hospital from 2010 to 2022 were collected. The information such as patient gender, age, suspected drugs, drug usage and dosage, blood uric acid level, ADR induction time, treatment and prognosis for statistical analysis was extracted.

Results There were 18 cases searched for literature, and our hospital reported 27 cases of hyperuricemia related to ADR, totaling 45 cases, including 25 males and 20 females, aged 14-82 years, with an average age of (53.18±19.45) years. Drug-induced hyperuricemia mainly involved antituberculosis drugs, diuretics, antiinfective drugs, compound antihypertensive drugs, antiplatelet drugs, proton pump inhibitors, immunomodulatory drugs and antipsychotics. Among the 45 patients after treatment, serum uric acid was >420-480 μmol·L^-1 in 4 cases, >480-540 μmol·L^-1 in 13 cases, and >540 μmol·L^-1 in 28 cases. The time it takes to induce hyperuricemia varies from 2 days to several years. After drug withdrawal, symptomatic treatment or dose reduction, blood uric acid level decreased or returned to normal.

Conclusions A variety of drugs can cause hyperuricemia. Patients taking these drugs, especially elderly patients, should monitor the blood uric acid levels regularly. Medical staff should know the drugs causing hyperuricemia, and do a good job in medication risk management to reduce the occurrence of drug-induced hyperuricemia.

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