Abstract

Gout is in the most common type of arthritis, occurs as a result of hyperuricemia. Xanthine oxidase inhibitors are generally recommended to treat gout. Despite the availability of treatment options, these therapies are associated with side effects. In this respect, natural remedies can prove advantageous. The purpose of this systematic review is to provide all-inclusive information on the available medicinal plants in Pakistan that have inhibitory effect on xanthine oxidase. An in-depth literature review indicates that no such studies are currently available to systematically shorten available data. This study was carried out in compliance with the PRISMA guidelines. Several databases, included Google Scholar, Web of Sciences, Scopus and PubMed were used for the search of literature from January 2000-April 2021. To assess the potential for bias, the SYRCLE RoB tool was used. There were 22 articles that met inclusion criteria. The study outcomes shown that the following plants had an increased inhibitory activity of XO (>75%); Zingiber officinale, Tribulus terrestris, Croton sparsiflorus, Laggera  aurita, Trianthema triquetra, Trachyspermum ammi and Bryophyllum pinnatum. Many phytochemicals were also identified with strong activity such as acacetin 1, umbelliferone, ranuncoside, chrysin 2, methyl-3,4,5-trihydroxybenzoate and costinone A. The current study will provide useful information on herbal medicines and serve as a reference for future studies on the treatment of gout. A thorough pharmacological and clinical evaluation of medicinal plants is necessary to assess their efficacy and safety.