Review of Urate-Lowering Therapeutics: From the Past to the Future

Christopher Jenkins; Jennifer H Hwang; Jeffrey B Kopp; Cheryl A Winkler; Sung Kweon Cho

doi:10.3389/fphar.2022.925219

Review of Urate-Lowering Therapeutics: From the Past to the Future

Front Pharmacol. 2022 Aug 23:13:925219. doi: 10.3389/fphar.2022.925219. eCollection 2022.

Authors

Christopher Jenkins^{1

2}, Jennifer H Hwang^{1

2}, Jeffrey B Kopp³, Cheryl A Winkler⁴, Sung Kweon Cho^{4

5}

Affiliations

¹ Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT, United States.
² Department of Internal Medicine, The Hospital of Central Connecticut, New Britain, CT, United States.
³ Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.
⁴ Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Leidos Biomedical Research, Frederick National Laboratory, Frederick, MD, United States.
⁵ Department of Pharmacology, Ajou University School of Medicine, Suwon, South Korea.

Abstract

We reviewed all currently available ULT, as well as any medications in development using following databases: United States Food and Drug Administration (FDA), European Medicines Agency (EMA), Japanese Pharmaceutical and Medical Devices Agency (PMDA), and ClinicalTrials.gov. We identified a total of 36 drugs, including 10 approved drugs, 17 in clinical testing phases, and 9 in preclinical developmental phases. The 26 drugs currently undergoing testing and development include 5 xanthine oxidase inhibitors, 14 uricosurics, 6 recombinant uricases, and one with multiple urate-lowering mechanisms of action. Herein, we reviewed the benefit and risk of each drug summarizing currently available drugs. New trials of uricosuric agents are underway to develop the new indication. New drugs are going on to improve the potency of recombinant uricase and to develop the new route administration of such as oral formulation. This review will provide valuable information on the properties, indications, and limitations of ULTs.

Keywords: ULT; drug; gout; review; uric acid.

Publication types

Review