Asymptomatic and Symptomatic Hyperuricemia: an Innovative Treatment Strategy

Abstract

Asymptomatic hyperuricemia is associated with many somatic diseases, the onset and progression of chronic kidney disease (CKD), with an increase in cardiovascular and general mortality. Symptomatic hyperuricemia – gout and various variants of kidney damage, despite the availability of modern rheumatological, urological and nephrological guidelines, does not lose its relevance, as it is characterized by a severe course, significantly worsens the quality of life, increases cardiovascular risk and leads to disability. Hyperuricemia is a persistent increase in the concentration of uric acid (UA) in blood serum (above 360 μmol/l). The appointment of urate-lowering therapy (ULT) for gout is based on the Guidelines of the American College of Rheumatology (ACR, 2020), the European League Against Rheumatism (EULAR, 2016), the National Institute for Health and Care Excellence (NICE, 2022), in the case of urolithiasis – the Guidelines of the European Association of Urology (EAU, 2023) and the American Urological Association (AUA, 2019). Asymptomatic hyperuricemia, from the point of view of the evidence base, requires only the use of lifestyle modification measures. The Austrian Society of Rheumatology and Rehabilitation for patients with gout and hyperuricemia in 2022 proposed dietary and lifestyle recommendations, including sour cherries (Montmorency), which can lower UA levels. Combination of concentrated Montmorency tart cherry powder (1:50) and dry willow extract is an innovative strategy for the treatment of asymptomatic and symptomatic hyperuricemia, a natural hypouricemic agent with an anti-inflammatory effect, which is prescribed as a complementary therapy for gout and hyperuricemia in: cardiovascular diseases, diabetes and metabolic syndrome, CKD, urolithiasis. The appointment of сombination of concentrated Montmorency tart cherry powder (1:50) and dry willow extract will contribute to the achievement of the target value of the UA level in the blood serum of patients with asymptomatic and symptomatic hyperuricemia, the initiation of reno- and cardioprotection, the reduction of the risk of gout attacks, and the achievement of a stable and long interrelapse period.