Overview of the pharmacokinetics and pharmacodynamics of URAT1 inhibitors for the treatment of hyperuricemia and gout

Expert Opin Drug Metab Toxicol. 2023 Dec;19(12):895-909. doi: 10.1080/17425255.2023.2287477. Epub 2024 Jan 12.

Abstract

Introduction: Hyperuricemia is a common metabolic disease, which is a risk factor for gouty arthritis and ureteral stones and may also lead to cardiovascular and chronic kidney disease (CDK). Therefore, hyperuricemia should be treated early. Xanthine oxidase inhibitors (XOIs) and uricosuric agents (UAs), which target uric acid, are two types of medications that are used to treat gout and hyperuricemia. XOIs stop the body from producing excessive uric acid, while UAs eliminate it rapidly via the kidneys. Urate transporter 1 (URAT1) belongs to the organic anion transporter family (OAT) and is specifically localized to the apical membrane of the epithelial cells of proximal tubules. Unlike other organic anion transporter family members, URAT1 identifies and transports organic anions that are primarily responsible for urate transport.

Areas covered: This article reviews the pharmacokinetics and pharmacodynamics of the existing URAT1 inhibitors to serve as a reference for subsequent drug studies.

Expert opinion: The URAT1 inhibitors that are currently used as clinical drugs mainly include dotinurad, benzbromarone, and probenecid. Results indicate that RDEA3170 may be the most promising inhibitor, in addition to SHR4640, URC-102, and MBX-102, which are in the early stages of development.

Keywords: URAT1; benzbromarone; dotinurad; gout; hyperuricemia; pharmacodynamics; pharmacokinetics.

Publication types

  • Review

MeSH terms

  • Gout* / drug therapy
  • Humans
  • Hyperuricemia* / drug therapy
  • Hyperuricemia* / metabolism
  • Organic Anion Transporters* / metabolism
  • Organic Cation Transport Proteins / metabolism
  • Uric Acid / metabolism
  • Uric Acid / therapeutic use

Substances

  • Uric Acid
  • Organic Cation Transport Proteins
  • Organic Anion Transporters