Renal safety and urate-lowering efficacy of febuxostat in gout patients with stage 4-5 chronic kidney disease not yet on dialysis.

Abstract

BACKGROUND/AIMS:

The safety and efficacy of febuxostat in patients with stage 4-5 chronic kidney disease (CKD) are still unclear owing to a lack of studies in these patients. Therefore, we aimed to evaluate the effect of febuxostat on renal function, general safety, and efficacy in gout patients with stage 4-5 CKD.

METHODS:

Among 739 patients who had been administered febuxostat from May 2012 to December 2016 at a single hospital in Korea, 370 patients who had been monitored for 1 year were analyzed. Serum uric acid levels and estimated glomerular filtration rate (eGFR) of patients with gouty arthritis were collected at baseline and 1 year after febuxostat administration.

RESULTS:

Among the 370 patients, 280 patients were stage 1-3 CKD, 63 patients were stage 4-5 CKD, and 27 patients were on dialysis. The eGFR of 63 patients with stage 4-5 CKD, excluding dialysis patients, was 19.84 ± 7.08 mL/min/1.73 m2 when they began to take febuxostat and 23.49 ± 16.67 mL/min/1.73 m2 after 12 months (p = 0.13). The urate-lowering effect after 12 months of febuxostat medication showed statistical significance (8.96 ± 2.31 mg/dL at baseline and 4.88 ± 1.68 mg/dL after 12 months, p < 0.01). The difference in incidence of adverse events among patients with stage 1-3 CKD, those with stage 4-5 CKD, and those on dialysis was not significant.

CONCLUSION:

Febuxostat demonstrated renal safety and good urate-lowering efficacy in gout patients with stage 4-5 CKD, who are not yet on dialysis.

• Authors: Sang-Hyon Kim, So-Yeon Lee, Ji-Min Kim, Chang-Nam Son
• Journal: The Korean journal of internal medicine (Korean J Intern Med) Vol. 35 Issue 4 Pg. 998-1003 (07 2020) ISSN: 2005-6648 [Electronic] Korea (South)
• PMID: 30959584 (Publication Type: Journal Article)

Chemical References

• Gout Suppressants
• Febuxostat
• Uric Acid
• Allopurinol

Topics

• Allopurinol (therapeutic use)
• Febuxostat (adverse effects)
• Gout (complications, diagnosis, drug therapy)
• Gout Suppressants (adverse effects)
• Humans
• Hyperuricemia (complications, diagnosis, drug therapy)
• Renal Dialysis
• Renal Insufficiency, Chronic (complications, diagnosis, therapy)
• Republic of Korea
• Treatment Outcome
• Uric Acid