高尿酸血症与痛风个体化治疗及临床用药新进展OA

The current trend toward a younger onset of hyperuricemia and gout,coupled with superimposed multisystem comorbidities,poses substantial challenges to clinical management.Based on recent domestic and international research advances,this review delineates stratified anti-inflammatory strategies for acute gout flares and urate-lowering regimens during the intercritical period,and compares the efficacy and safety limitations of conventional pharmacotherapies.It focuses on the research and development prospects of innovative therapeutic agents,including nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3(NLRP3)inflammasome antagonists,novel urate transporter 1(URAT1)inhibitors,and dual-target agents with both anti-inflammatory and urate-lowering properties.Furthermore,this review emphasizes the importance of foundational interventions such as lifestyle modification and gut microbiota regulation,and highlights the pharmacotherapeutic dilemmas encountered in special populations(adolescents,pregnant and lactating women,and men preparing for conception),as well as key intervention principles in managing gout with concomitant cardio-renal metabolic diseases and upper gastrointestinal bleeding.This review also elucidates the deficiencies in the current diagnostic and therapeutic paradigm,including the slow clinical translation of novel drugs,the absence of treatment protocols for special populations,and inadequate elucidation of comorbidity mechanisms,with the aim of providing references for future precise,individualized clinical diagnosis and treatment,and scientific innovation in hyperuricemia and gout.