Uricosuric drugs: the once and future therapy for hyperuricemia?
OBJECTIVE
Although uricosuric agents provide the most time-honoured approach to the control of hyperuricemia, their place in the armamentarium has been eclipsed by that of xanthine oxidase inhibitors. This review considers the potential for uricosuric agents from the perspective of recent progress in the understanding of urate transport systems.


RESULTS
No new agents have yet become available, but promising new drugs are under development. Better understanding of the transporters URAT1 and ABCG2 in particular would appear to provide opportunities for more selective, better tolerated agents to increase the renal clearance of uric acid and thereby control hyperuricemia.


CONCLUSIONS
Conceptually, modest inhibition of renal tubular reabsorption should provide effective relief for the millions of individuals who are now hyperuricemic and who suffer from its principal consequence, gout.
Department of Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA.
Mary H
MH
Bach
Peter A
PA
Simkin
D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters / Q000378:metabolism; D055808:Drug Discovery; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D051246:Glucose Transport Proteins, Facilitative / Q000378:metabolism; D006073:Gout / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects; D033461:Hyperuricemia / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism; D007687:Kidney Tubules, Proximal / Q000187:drug effects / Q000378:metabolism; D009363:Neoplasm Proteins / Q000378:metabolism; D027361:Organic Anion Transporters / Q000378:metabolism; D027701:Organic Cation Transport Proteins / Q000378:metabolism; D011339:Probenecid / Q000627:therapeutic use; D014527:Uric Acid / Q000378:metabolism; D014528:Uricosuric Agents / Q000627:therapeutic use*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
C116614:ABCG2 protein, human; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters; D004791:Enzyme Inhibitors; D051246:Glucose Transport Proteins, Facilitative; D009363:Neoplasm Proteins; D027361:Organic Anion Transporters; D027701:Organic Cation Transport Proteins; C491241:SLC22A12 protein, human; C411811:SLC2A9 protein, human; D014528:Uricosuric Agents; D006852:Hydrochlorothiazide; D014527:Uric Acid; D014969:Xanthine Oxidase; D011339:Probenecid