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Modified Simiao Pills (also known as modified Simiao decoction or Jiawei Simiao Pills) is a traditional Chinese medicine (TCM) herbal formula derived from the classic Simiao Pill (composed of Rhizoma Atractylodis, Cortex Phellodendri, Radix Achyranthis Bidentatae, and Semen Coicis). It is widely used in China for the treatment of hyperuricemia, gout, and gouty arthritis. The formula exerts its therapeutic effects through multi-target mechanisms, including the inhibition of xanthine oxidase (XOD) to reduce uric acid production, and the regulation of renal urate transporters such as URAT1, GLUT9, and OAT1 to promote uric acid excretion. Additionally, it exhibits anti-inflammatory properties by suppressing the NLRP3 inflammasome and reducing pro-inflammatory cytokines. Clinical trials, including those sponsored by the Guangdong Provincial Hospital of Chinese Medicine, have evaluated modified Simiao Pills in combination with Western therapies like benzbromarone for managing hyperuricemia and preventing gout flares.
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