Effect of micronized fenofibrate and losartan combination on uric acid metabolism in hypertensive patients with hyperuricemia

It has been reported that micronized fenofibrate and losartan can significa ntly decrease serum uric acid levels by augmenting uric acid excretion, Wt undertook this study to evaluate the effects of the combination treatment w ith micronized fenofibrate and losartan in nondiabetic hypertensive dyslipi demic patients with hyperuricemia (serum uric acid, >7 mg/dl). A total of 2 5 patients (15 men, 10 women) aged 21-66 years was studied. In all patients , serum lipid parameters, including Lp(a), fibrinogen, and uric acid levels , as well as fractional excretion of uric acid (FEUA) were obtained before treatment, 8 weeks after micronized fenofibrate treatment (200 mg daily), a nd 8 weeks after combination therapy with micronized fenofibrate (200 mg da ily) and losartan (50 mg daily). Fenofibrute alone significantly decreased total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides , Apo B, Lp(a), fibrinogen, and uric acid levels (from 7.6 +/- 0.55 to 5.6 +/- 0.5 mg/dl; p < 0.0001) and increased high-density lipoprotein (HDL) cho lesterol, Apo A,, and FEUA (from 6.5 +/- 1.8% to 12.2 +/- 4%: p < 0.0001). The addition of losartan beyond the decrease in blood pressure values did n ot significantly alter serum metabolic parameters. However, a small additio nal decrease in serum uric acid levels (from 5.6 +/- 0.5 to 4.9 +/- 1 mg/dl ; p < 0.05) was found because of a further increase in FEUA (from 12.2 +/- 4% to 14 +/- 5.5%; p < 0.05). It is concluded that the combination of micro nized fenofibrate and losartan is useful for the management of patients wit h multiple metabolic abnormalities, including hyperuricemia.