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Probenecid – More than a Gout Drug
Probenecid – More than a Gout Drug

We can see from the 2020 ACR probenecid guidelines that probenecid is a recommended treatment for uric acid. So it definitely is a gout treatment. But my review of probenecid side effects research shows that it is much more than that. With potential applications in many diseases.

My approach to selecting gout treatments is to start with the 2020 ACR guidelines. Then also consider specific patient concerns. And research since 2020. So my approach here is:

  1. Learn how the 2020 ACR Probenecid Guidelines affect you.
  2. If you are concerned about side effects, check if any Probenecid Side Effects Research Studies are relevant to you.
  3. If you have comorbidities, check if any recent research listed below is relevant to you.

Probenecid Recent Research

I found 5 probenecid studies since 2020. All of which mention its role as a uric acid treatment in gout. However, each study is mostly concerned with diseases other than gout.

Probenecid & Bone Disease

My first study investigates bone diseases such as rheumatoid arthritis and osteoporosis.

Cheng, M.H. and Kim, S.J., 2020. Inhibitory effect of probenecid on osteoclast formation via JNK, ROS and COX-2. Biomolecules & Therapeutics, 28(1), p.104.

our results suggest that probenecid could potentially be used as a new therapeutic agent for the treatment of metabolic bone diseases such as osteoarthritis, osteoporosis and rheumatic arthritis.

Probenecid and Near-Birth Heart Disease

Peripartum cardiomyopathy (PPCM) is a potentially life-threatening disease. Where a mother's heart loses function between the last month of pregnancy and first few months of birth.

Onusko, E., McDermott, M.R., Robbins, N., Liu, G., Kranias, E.G., Rubinstein, J. and Koch, S.E., 2020. Probenecid treatment improves outcomes in a novel mouse model of peripartum cardiomyopathy. Plos one, 15(3), p.e0230386.

probenecid improves survival in a novel mouse model of PPCM by improving contractility and reducing LV (left ventricular) remodeling

Probenecid & Heart Function

This laboratory study explains some new facts about how probenecid might improve heart functions.

Rubinstein, J., Woo, J.G., Garcia, A.M., Alsaied, T., Li, J., Lunde, P.K., Moore, R.A., Laasmaa, M., Sammons, A., Mays, W.A. and Miyamoto, S.D., 2020. Probenecid improves cardiac function in subjects with a fontan circulation and augments cardiomyocyte calcium homeostasis. Pediatric Cardiology, 41(8), pp.1675-1688.

the information provided by this study can educate future studies that may seek to personalize the dosing and timing of probenecid therapy based on degree of disease progression

Probenecid & Uric Acid

This study explains how probenecid singles out uric acid for excretion. While encouraging increased levels of other potentially beneficial substances.

Granados, J.C., Bhatnagar, V. and Nigam, S.K., 2022. Blockade of organic anion transport in humans after treatment with the drug probenecid leads to major metabolic alterations in plasma and urine. Clinical Pharmacology & Therapeutics.

97 metabolites that were significantly elevated in the plasma and decreased in the urine, indicating OAT-mediated clearance. These included signaling molecules, antioxidants, and gut microbiome products. In contrast, urate was the only metabolite significantly decreased in the plasma and elevated in the urine

Probenecid & Kidney Injury

My final study investigates probenecid as a potential treatment for kidney injury. Because it has been shown to protect against brain and heart diseases.

El-Maadawy, W.H., Hassan, M., Badawy, M.H., AbuSeada, A. and Hafiz, E., 2022. Probenecid induces the recovery of renal ischemia/reperfusion injury via the blockade of Pannexin 1/P2X7 receptor axis. Life Sciences, 308, p.120933.

Our study elaborates for the first time the effectiveness of PBN [probenecid] in recovering post-ischemic renal injury [RI] […] Therefore, PBN can be considered a promising drug for RI/RI treatment.

Probenecid Clinical Trials

Clinical trials are a precursor to the most relevant probenecid research. So with 55 trials at the time of writing. We might expect some interesting new developments for gout treatment. However, only 1 of the 55 trials involves gout patients. And even that study is designed to measure the effects of probenecid on dementia.

Rishi J. Desai, 2021. Data Analysis for Drug Repurposing for Effective Alzheimer's Medicines- Probenecid vs Allopurinol. Identifier: NCT04746989

This study aims to evaluate the comparative risk of dementia/Alzheimer's disease onset between patients treated with medications that target specific metabolic pathways and patients treated with alternative medications for the same indication using healthcare claims data.

The other probenecid clinical trials cover many diseases. Including:

  • Alcohol use disorder
  • Bacterial infection
  • Cellulitis
  • COVID-19
  • CPPD - Calcium Pyrophosphate Deposition Disease
  • Diabetes
  • Heart failure
  • HIV Infections
  • Influenza
  • Morphine dependence
  • Obesity
  • Syphilis
  • Urinary Tract Infections
Probenecid – More than a Gout Drug
Probenecid – More than a Gout Drug

Your Probenecid for Gout Story

Which aspects of probenecid for gout are you concerned about?

Please tell me your probenecid for gout story in the Gout Forum.

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