Effect of fenofibrate in combination with urate lowering agents in patients with gout.
BACKGROUND
To assess the efficacy of fenofibrate treatment in combination with urate lowering agents in patients with gout.


METHODS
Fourteen male patients with chronic tophaceous or recurrent acute attacks of gout were evaluated in an open-label pilot study of the hypolipidemic agent, fenofibrate (Lipidil Supra 160 mg/d). Patients were stable on urate lowering agents (allopurinol or benzbromarone) for > or = three months without acute attack for the most recent one month before participating. All patients were being treated with established doses of urate lowering agents without modification throughout the study. Clinical and biochemical assessments including serum uric acid, creatinine, liver function test and fasting serum lipid were measured at (1) baseline (2) after two months of fenofibrate treatment and (3) two months after fenofibrate was withdrawn.


RESULTS
Serum uric acid was lowered by 23% after two months of fenofibrate treatment (6.93 +/- 2.16 vs. 5.22 +/- 1.16 mg/dL; p = 0.016). Triglyceride levels were also reduced after fenofibrate treatment (p = 0.001). However, this effect was reversed after the withdrawal (p = 0.002) of the drug. Alkaline phosphatase was reduced after fenofibrate treatment (p = 0.006), but increased 21% after the withdrawal of the drug (p = 0.002). By contrast, serum levels of high density lipoprotein and creatinine were increased 9% (p = 0.018) and 12% (p = 0.006), respectively; however, both levels were significantly decreased to the baseline levels upon withdrawal of fenofibrate.


CONCLUSIONS
Fenofibrate can effectively reduce uric acid levels in addition to its known hypolipidemic effect. Fenofibrate may be used as a potential urate lowering agent in patients with gout, especially in those with coexisting hyperlipidemia.
Lee
You-Hyun
YH
Division of Rheumatology, College of Medicine, Ewha Womans University, Seoul, Korea.
Lee
Chan-Hee
CH
Lee
Jisoo
J
D000328:Adult; D000368:Aged; D011345:Fenofibrate / Q000008:administration & dosage*; D006073:Gout / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D014527:Uric Acid / Q000097:blood; D014528:Uricosuric Agents / Q000008:administration & dosage*
D008055:Lipids; D014528:Uricosuric Agents; D014527:Uric Acid; D011345:Fenofibrate