Wednesday, 25 Apr 2018

You are here

FIELD Study: Fenofibrate Reduces Uric Acid and Gout Risk

Lancet reports the results of the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study - where fenofibrate was shown to reduce uric acid by 20%, gout events by nearly 50% and may be useful in preventing gout in diabetes. 

In the study, 9795 adults (age 50–75 years) with type 2 diabetes were randomized to receive fenofibrate 200 mg per day or placebo and followed for up to 5 years.

In the fenofibrate group, serum uric acid levels fell by 20·2% during a 6-week active fenofibrate run-in period (a reduction of 0·06 mmol/L or 1 mg/dL) and remained −20·1% (p<0·0001) lower for those re-measured at 1 year.

First new gout events were seen in 3% of placebo and 2% of fenofibrate patients during 5 years of follow-up (HR 0·54, 95% CI 0·41–0·70; p<0·0001).

Cumulative gout attacks were higher In the placebo group based on baseline uric acid concentration (7·7% or 13.9% if higher than 0·36 mmol/L or 0·42 mmol/L) versus only 3·4% or 5·7% in the fenofibrate group.

Analyzing all gout events, fenofibrate reduced the risk of gout events by 52% (HR 0·48, 95% CI 0·37–0·60; p<0·0001) compared with placebo.

Previous small and short term studies have shown fenofibrate to lower uric acid and reduces gout attacks.  The current study shows a sustained 20% reduction in uric acid levels that translates to fewer cases of incident gout in those with diabetes.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Unmet Needs in Calcium Pyrophosphate Deposition Disease

Abhishek et al have written on the results of an international survey of crystal arthritis experts and identified the unmet needs  regarding calcium pyrophosphate crystal deposition (CPPD) - research, classification, diagnosis and management.

CPPD is a highly prevalent condition with a range of manifestations that may lead to pain, synovitis and joint damage, especially in the elderly.

Time to Rethink Gout as a Chronic Disease

The current issue of JAMA has a perspective article on Gout’s bad rap as dietary disease rather than the complex, chronic inflammatory disorder that is ineffectively treated in many. 

The author and experts interviewed believe that the pipeline of new drugs for gout will fuel the future of evidence-based care and more informed lifestyle instruction.

Does Dose Escalation Help in Gout?

Contrary to expectations, dose escalation of allopurinol among patients with gout did not improve survival, a 10-year observational study found.

CARES Study- More CV Deaths with Febuxostat

The CARES study was presented Monday at the American College of Cardiology meeting in Orlando and finds that while the rates of all major cardiovascular (CV) events were comparable between febuxostat or allopurinol, there were more CV deaths with febuxostat. (Citation source bit.ly/2HtUEaz)

Gout Crystal Deposition is Deeper than its Measures

Dalbeth and colleagues have published that among gout patients without palpable tophic and despite long term allopurinol, nearly half have monosodium urate (MSU) as detected by Dual-energy CT (DECT).  The total body urate deposition is even greater in those with higher sUA and evidence of severe disease.