Hyperuricemia management in patients without clinical gout

Robert McLean, MD, is a rheumatologist and associate clinical professor of medicine at Yale School of Medicine, USA.

Should we treat hyperuricemia without clinically relevant gout?

The actual straight answer is no. If someone does not have clinical gout, from a rheumatologic perspective, there is really no good reason and guidelines would suggest that we should not be treating hyperuricemia. I mean, if someone has kidney stones related to uric acid, that’s a completely different situation, so I think that would be appropriate.

There’s really very interesting evolving literature on whether hyperuricemia in and of itself is a risk factor for cardiovascular disease and hypertension, but there are no good studies that would suggest at this point that we should be treating people who do not have gout, but who have hyperuricemia.