Risk factors for hyperuricemia with HMG-CoA reductase inhibitors using a postmarketing surveillance database in Japan

Background: Little is known about whether HMG-CoA reductase inhibitor(statin)treatment exerts an adverse effect on serum levels of uric acid. It remains unknown whether statin use is associated with an increased risk of hyperuricemia. The purpose of this study was to identify the risk factors for developing hyperuricemia or blood uric acid elevation associated with statin use utilizing the Japanese RAD-AR postmarketing surveillance database. Methods: We performed a nested case-control study using a postmarketing surveillance database in Japan. The database cohort included 26,914 cases of statin use in patients with hyperlipidemia. Participants received at least one type of statin, had a clear medication history of statin use, and no complication of hyperuricemia. Cases were defined as onset of hyperuricemia or blood uric acid elevation during statin intake. For each case, 20 controls were randomly selected and matched by time-point. The factors associated with an increased risk of hyperuricemia or blood uric acid elevation during statin intake examined included sex, age, body mass index, statin use duration, complications, concomitant medications, and clinical laboratory test values. Statin-associated hyperuricemia or blood uric acid elevation was identified based on abnormal elevation of blood uric acid concentrations beyond the reference range. Results: A total of 20,783 patients met the inclusion criteria, of whom 23 were in the case group. Two complicating factors, sympathetic inhibitory antihypertensive drugs (adjusted odds ratio［OR］: 4.22)and triglyceride level(adjusted OR: 2.48), were extracted for onset of hyperuricemia or blood uric acid elevation. Conclusion: This study suggested that the onset of hyperuricemia or blood uric acid elevation might increase with statin use in patients with complications of hypertriglyceridemia and concomitant administration of sympathetic inhibitory antihypertensive drugs.