Hyperuricemia in patients with spondyloarthritis
DOI: 10.32364/2587-6821-2026-10-3-3
Hyperuricemia in patients with spondyloarthritis
А.Yu. Tsinzerling1,2, O.V. Inamova1,2, I.Z. Gaydukova1,3
1North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation
2V.A. Nasonova St. Petersburg Clinical Rheumatology Hospital, St. Petersburg, Russian Federation
3Russian University of Medicine, Moscow, Russian Federation
Aim: to analyze an association of hyperuricemia (HU) with clinical manifestations and comorbidity incidence in spondyloarthritis (SpA) patients, as well as to evaluate prescription rate and effectiveness of urate-lowering therapy (ULT) in real-world clinical practice.
Materials and Methods: pursuant to the St. Petersburg Rheumatology Registry, two age- and sex-matched groups of SpA patients (n=202) (SpA + HU [n=96] and SpA without HU [n=106]) were analyzed. HU was recorded at uric acid (UA) level ≥360 μmol/L at least twice.
Results: peripheral arthritis was less common in patients with HU (60.4% vs. 73.6%; p=0.04). In case of axial involvment onset, HU patients had higher ESR (24 [15; 32] mm/h vs. 15 [8; 25] mm/h; p=0.02). In HU patients, uveitis was associated with higher CRP level (24 [14; 31.4] mg/L vs. 9.4 [9; 23] mg/L; p=0.04). HU was associated with significantly higher incidence (p<0.001) of hypertension (61.5% vs. 21.7%), obesity (32.3% vs. 2.8%), type 2 diabetes (21.9% vs. 0.9%), MAFLD (33.3% vs. 10.4%), and CKD (33.3% vs. 16.0%). Target uric acid levels were achieved in 54.5% of patients with peripheral SpA receiving allopurinol (203±34.5 mg/day). In case of axial SpA, >30% of patients refused ULT; effectiveness was 14.8% in subjects followed special diet, and it was 17.5% in patients received allopurinol (86.5±22.6 mg/day) (p<0.001).
Conclusion: in SpA patients, HU is associated with axial involvement, active uveitis, and increased incidence of cardiovascular diseases, metabolic disorders, and CKD. As effectiveness of ULT is significantly higher in individuals with peripheral SpA (54.5%) than in those with axial SpA (17.5%), this requires a differentiated therapeutic approach.
Keywords: hyperuricemia, uric acid, spondyloarthritis, comorbidity, urate-lowering therapy, allopurinol.
For citation: Tsinzerling А.Yu., Inamova O.V., Gaydukova I.Z. Hyperuricemia in patients with spondyloarthritis. Russian Medical Inquiry. 2026;10(3):122–128 (in Russ.). DOI: 10.32364/2587-6821-2026-10-3-3
About the authors:
Alexandra Yu. Tsinzerling — C. Sc. (Med.), Rheumatologist, V.A. Nasonova St. Petersburg Clinical Rheumatology Hospital; 30, Bolshaya Podyacheskaya str., St. Petersburg, 190068, Russian Federation; Senior Assistant at the E.E. Eichwald Department of Internal Medicine, Rheumatology, Examination of Temporary Disability and Quality of Medical Care with a Course of Hematology and Transfusiology, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0003-4860-0518
Oksana V. Inamova — C. Sc. (Med.), Chief Medical Officer, V.A. Nasonova St. Petersburg Clinical Rheumatology Hospital; 30, Bolshaya Podyakskaya str., St. Petersburg, 190068, Russian Federation; Deputy Director for Work with Clinical Bases of the Research Institute of Rheumatology, North-Western State Medical University named after I.I. Mechnikov; Assistant Professor of the Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care named after E.E. Eichwald, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0001-9126-3639
Inna Z. Gaydukova — D. Sc. (Med.), Professor of the E.E. Eichwald Department of Internal Medicine, Rheumatology, Examination of Temporary Disability and Quality of Medical Care, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; Head of the Department of Rheumatology, Faculty of General Medicine, N.A. Semashko Scientific and Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0003-3500-7256
Contact information: Alexandra Yu. Tsinserling, e-mail: aleksa.fonturenko@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 03.03.2026.
Revised 16.03.2026.
Accepted 27.03.2026.
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