Friday, 18 Oct 2019

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

Anakinra Use in Hospitalized Gout Patients

While the efficacy and safety of interleukin 1 (IL-1) inhibitors (e.g., anakinra) in the acute management of gout and pseudogout has been repeatedly shown, the cost efficacy of such biologic therapy has rendered it impractical for most. A new retrospective study has shown that IL-1 inhibitors may be effective and appropriate for some medically complex, hospitalized patients with acute gout or calcium pyrophosphate crystal arthritis.

Higher Rates of Venous Thromboembolism in Gout

A Canadian administrative claims analysis has shown that gout-associated inflammation increases the risk of venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE) before and after the diagnosis of gout.

Modifiable Risk Factors for Hyperuricemia

Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia. 

Researchers examine modifiable risk factors for hyperuricemia and how this could be prevented through risk factor modification in the general population.

Opioids Overused in Acute Gout

Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.

Allopurinol Fails to Curtail Hypertension

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.