CRYSTAL DEPOSITION DISEASES: Edited by Sara K. TedeschiMedications for gout and its comorbidities: mutual benefits?Yoshida, Kazukia,b; Choi, Hyon K.b,c; Solomon, Daniel H.a,b,dAuthor Information aDivision of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital bHarvard Medical School cDivision of Rheumatology, Allergy & Immunology, Department of Medicine, Massachusetts General Hospital dDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Correspondence to Dr Kazuki Yoshida, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, Boston, Massachusetts 02115, USA. E-mail: [email protected] Current Opinion in Rheumatology: March 2021 - Volume 33 - Issue 2 - p 145-154 doi: 10.1097/BOR.0000000000000784 Buy Metrics Abstract Purpose of review To review recent literature with relevance to the management of multimorbid patients with gout, i.e., gout medication repurposed for comorbidities and vice versa. Recent findings Adding to the previous success of interleukin-1 inhibition, two trials on low-dose colchicine's role in cardiovascular disease (CVD) demonstrated potential benefits in patients with or without gout. In Colchicine Cardiovascular Outcomes Trial, a composite CVD endpoint was reduced by 23% among patients who had experienced a recent myocardial infarction. In Low-Dose Colchicine 2, the composite CVD endpoint was reduced 31% among those with stable coronary artery disease. Use of urate-lowering therapy (ULT) for renal protection in patients without gout produced null results. Allopurinol did not benefit the glomerular filtration rate in two trials (Controlled trial of slowing of Kidney Disease progression From the Inhibition of Xanthine oxidase and Preventing Early Renal Function Loss) among patients with chronic kidney disease (with or without hyperuricemia, but not gout). SGLT-2 inhibitors, a medication recommended for patients with diabetes and CVD, diabetic kidney disease, or heart failure, demonstrated a protective effect against gout flares in a secondary trial analysis and a large observational study. Summary The role of colchicine may expand beyond gout flare prevention to patients with existing CVD. The renal benefit of ULT among patients with gout remains unclear. SGLT-2 inhibitors may benefit diabetic patients who have gout as a comorbidity. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.