Dotinurad, as a uric acid excretion enhancer, can be used for long-term treatment of gout/hyperuricemia under the guidance of a physician, but its efficacy and safety need to be evaluated regularly. Long term use requires comprehensive consideration of factors such as patient kidney function, uric acid levels, and adverse drug reactions.

Feasibility of long-term medication

(1) Drug mechanism: By selectively inhibiting URAT1 to promote uric acid excretion, it is suitable for long-term management of chronic hyperuricemia.

(2) Clinical data: A Phase III study in Japan showed that continuous medication for 2 years can maintain a stable uric acid lowering effect with a lower incidence of adverse events.

Long term medication monitoring requirements

(1) Renal function monitoring: Check blood creatinine and estimate glomerular filtration rate (eGFR) at least every 3 months.

(2) Uric acid level: tested monthly during the initial stage of treatment, and rechecked every 3 months after stabilization to maintain a target value of<6mg/dL.

3 Special precautions

(1) Renal insufficiency: eGFR<30mL/min is contraindicated, and 30-60mL/min should be reduced and monitored more closely.

(2) Combination therapy: Avoid using drugs that promote uric acid elevation such as pyrazinamide and ethambutol in combination.

4 Adverse Reaction Management

(1) Common reactions: Long term medication requires attention to renal dysfunction, elevated liver enzymes, and the risk of urinary tract stones.

(2) Intervention measures: When hematuria or lower back pain occurs, urinary tract stones should be immediately checked and medication should be suspended if necessary.