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Hyperurikämie

Wann und wie behandeln?

Hyperuricemia

When and how to treat?

  • Arzneimitteltherapie
  • Published:
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Zusammenfassung

Die Prävalenz der asymptomatischen Hyperurikämie und der klinisch manifesten Gicht hat in den letzten Jahren erheblich zugenommen. Grundlegende Änderungen des Lebensstils, die deutliche Zunahme der Adipositasprävalenz und des metabolischen Syndroms sowie das steigende Alter der Patienten sind wichtige Ursachen dieser Entwicklung. Daher gewinnt die Frage der medikamentösen Therapie einer Harnsäuresenkung wieder an Bedeutung, insbesondere auch, da in den letzten Jahren nach Jahrzehnten des therapeutischen Stillstands neue Medikamente für die medikamentöse Harnsäuresenkung zugelassen wurden und weitere in klinischer Prüfung sind. Europäische und amerikanische Leitlinien zur Therapie der Hyperurikämie wurden in den vergangenen Jahren aktualisiert und überarbeitet. Auch die Rolle der asymptomatischen Hyperurikämie als kardiovaskulärer Risikofaktor ist erneut Gegenstand intensiver und auch kontroverser Diskussionen. Die vorliegende Übersicht soll die aktuellen Kenntnisse einordnen helfen und einen Überblick über die empfohlenen Therapiestrategien zur Harnsäuresenkung geben.

Abstract

The prevalence of (asymptomatic) hyperuricemia and gout has substantially increased in recent decades. This development is due to fundamental lifestyle changes, dramatically rising prevalence of obesity and metabolic syndrome, as well as the increasing age of patients. Therefore, medical treatment of hyperuricemia has regained interest in recent years, in particular since after decades of therapeutic stagnation, new treatments of hyperuricemia have been approved or are currently being investigated in clinical trials. European and American guidelines/recommendations for treatment of hyperuricemia and gout have been updated and revised. Furthermore, the role of asymptomatic hyperuricemia as an (independent) cardiovascular risk factor is again under debate. This article provides assistance in integrating our present knowledge in a therapeutic context and summarizes currently recommended treatment strategies.

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Correspondence to M. A. Reuss-Borst.

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M. A. Reuss-Borst hat Honorare für Vorträge von Berlin-Chemie und Novartis erhalten.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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M. Wehling, Mannheim

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Reuss-Borst, M.A. Hyperurikämie. Internist 57, 194–201 (2016). https://doi.org/10.1007/s00108-015-0001-y

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