Febuxostat demonstrates efficacy and renal safety in patients with gout and CKD

Peiyu Zhang et al conducted a study to explore the efficacy and renal safety of febuxostat in gout and stage 2-4 chronic kidney disease (CKD) and factors that correlated with target serum urate (SU).The article has been published in Rheumatology therapy journal.

A single-center retrospective study including male patients with gout and CKD was conducted. SU, the rate of SU < 360 umol/L (RAT), and renal safety were analyzed in subjects who received febuxostat over 44 weeks.

Key findings of the study were:

• 102 patients (stage 2 CKD: n = 27; stage 3 CKD: n = 70; stage 4 CKD: n = 5) were enrolled.

• The SU level reduced significantly over 44 weeks (600.76 ± 95.42 versus 405.52 ± 111.93 umol/ L; P <0.05), and RAT increased to 39.20%.

• The overall estimated glomerular filtration rate (eGFR) level improved over 44 weeks (52.05 ± 11.68 versus 55.46 ± 14.49 mL/min/ 1.73 cm2, p <0.05).

• An obvious improvement of eGFR was observed in stage 3 CKD, in patients with <= 1 risk factor (hypertension, diabetic mellitus, hyperlipidemia, or usage of non-steroidal anti-inflammatory drugs), and in patients with terminal SU <360 umol/L (p <0.05).

• Logistic regression analysis indicated that baseline SU level and body weight were correlated with RAT.

• Patients with SU<600 umol/L and body weight <=70 kg reached higher RAT (56.7%).

The authors concluded that – "In patients with gout and CKD,  urate lowering treatment with febuxostat significantly reduces SU levels and could improve renal function. Significant improvement in renal function was achieved in patients with stage 3 CKD, without hypertension, diabetic mellitus, hyperlipidemia, or usage of NSAIDs. A ''treat to target'' therapy with febuxostat could obviously improve renal function. Besides, patients with baseline SU <600 umol/L and body weight B 70 kg were more likely to achieve target SU.

Further reading:

Febuxostat Therapy for Patients with Gout and Stage 2–4 CKD: a Retrospective Study

Peiyu Zhang, Mo Chen et al

Rheumatology Therapy (2022) 9:1421–1434

https://doi.org/10.1007/s40744-022-00480-7