Key result
NSAIDs are associated with cardiac risk and should be avoided in patients with CAD, whereas Interleukin-1 inhibitors appear to be safe alternatives for treating gout in these patients.
Why the study?
What is the cardiac safety of various pharmacotherapeutic options for managing gout in patients with underlying coronary artery disease?
What is the cardiac safety of various pharmacotherapeutic options for managing gout in patients with underlying coronary artery disease?
In patients with gout and underlying coronary artery disease, NSAIDs should be avoided due to cardiac risks, while Interleukin-1 inhibitors offer a safe alternative for acute flares.
Supports NSAID caution in CAD with gout; leaves open need for RCTs on IL-1 inhibitor safety.
INTRODUCTION: Hyperuricemia has been identified as an independent risk factor for coronary artery disease (CAD). Uric acid lowering therapy could potentially lower the risk of CAD. Conventional treatments have been effective in treating acute gout flares in most patients, but certain options, like NSAIDs could increase the risk of CAD. AREAS COVERED: This review covers the aspect of cardiac safety with traditional and new medications used in treating both acute flares and chronic gout according to the most recent international guidelines. EXPERT OPINION: All NSAIDs, not just selective Cox 2 inhibitors, have associated with them different degrees of cardiac risk; therefore, NSAIDs should be avoided when treating patients with underlying CAD. Interleukin-1 inhibitors appear to be safe alternatives for treating cardiac patients who are contraindicated to conventional treatment. Presently, there is a paucity of evidence concerning whether treatment of hyperuricemia could lower the risk of CAD and this must be explored further. It is also important to explore the cardiac safety of plegloticase to better ascertain its safety in CAD patients.
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Chan et al. (2018) conducted a review in Gout and coronary artery disease. Gout pharmacotherapy (NSAIDs, Interleukin-1 inhibitors) was evaluated on Cardiac safety. NSAIDs are associated with cardiac risk and should be avoided in patients with CAD, whereas Interleukin-1 inhibitors appear to be safe alternatives for treating gout in these patients.
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