Fenofibrate
Fenofibrate is emerging as a new possible prophylactic treatment for gout. The drug is
normally used to treat hyperlipidemia by decreasing triglyceride levels and increasing HDL
cholesterol levels (8). The drug has also been shown to lower serum urate levels. Long‐term
administration of fenofibrate has been associated with substantial and sustained decrease in
serum urate. It has also been associated with a decrease in acute gout attacks.
One case report explains how a Type II diabetes mellitus patient, with a history of
several gout attacks per year, has had no attacks since starting fenofibrate therapy (8). The
patient has also had no need for prophylaxis. Another case report shows a patient with a
history of gout responding well to fenofibrate therapy when other prophylactic treatments
have failed.
Fenofibrate increases renal clearance of uric acid, an effect not seen with other fibrates
(8). Although fenofibrate’s urate‐lowering effect is not as good as traditional uricosurics such as
probenecid, researchers are suggesting it may be used in combination with other anti‐gout
drugs. Fenofibrate looks to be a promising adjunct to anti‐gout therapy