Febuxostat Effectively Lowers Uric Acid in Gout Regardless of Renal Function: Study
South Korea: A study published in The Journal of Rheumatology found that febuxostat effectively reduces and maintains serum urate levels in patients with Gout, regardless of kidney function. The drug showed a strong early reduction in uric acid and demonstrated acceptable renal and hepatic safety, even in patients with Chronic Kidney Disease (CKD).
Gout is a common inflammatory arthritis caused by elevated serum urate levels and is frequently seen in individuals with impaired kidney function. Because CKD limits the excretion of uric acid, managing gout in these patients can be challenging, and concerns often arise regarding the safety and dosing of urate-lowering therapies. To better understand the effectiveness and safety of febuxostat in this population, researchers conducted a prospective multicenter analysis using data from the Urate-Lowering Therapy in Gout (ULTRA) registry.
The study was led by Yoon-Jeong Oh from the Division of Rheumatology, Department of Internal Medicine at Hallym University Dongtan Sacred Heart Hospital in South Korea, along with colleagues. The investigators analyzed patients enrolled in the ULTRA registry between November 2021 and December 2023 to examine how serum urate levels and febuxostat dosing changed over time in relation to kidney function.
Out of 405 patients recorded in the registry, 112 individuals were included in the final analysis after excluding those with less than one year of follow-up, those who were not receiving febuxostat therapy, and those with incomplete data. Participants were categorized by kidney function as CKD or normal renal function. Researchers compared serum urate levels and febuxostat doses at baseline, six months, and twelve months.
The study revealed the following findings:
- Baseline serum urate levels were similar in patients with and without Chronic Kidney Disease.
- After initiating Febuxostat therapy, patients with CKD experienced a greater reduction in serum urate levels compared with those with normal kidney function.
- At 6 months, the mean serum urate level was 4.45 mg/dL in the CKD group versus 5.62 mg/dL in the normal renal function group, showing a significant difference.
- At 12 months, serum urate levels remained lower in the CKD group (4.81 mg/dL) compared with patients without CKD (5.60 mg/dL).
- Patients with CKD received slightly lower doses of febuxostat during follow-up despite achieving better urate reduction.
- At 6 months, the mean febuxostat dose was 40.6 mg in the CKD group compared with 47.5 mg in patients with normal kidney function.
- A similar dosing trend persisted at 12 months, although the between-group differences were not statistically significant.
- A greater proportion of patients with CKD achieved the recommended serum urate target of <6 mg/dL.
- At 6 months, 91.2% of patients with CKD reached the urate target compared with 68.6% of those with normal kidney function.
Overall, the findings suggest that febuxostat can effectively control serum urate levels in gout patients across different levels of kidney function. The authors concluded that adjusting the dose based on a patient’s urate response, rather than relying solely on kidney function, may help clinicians achieve better treatment outcomes while maintaining safety.
Reference:Yoon-Jeong Oh, Hyo Jin Choi, Sang-Hyon Kim, You-Jung Ha, In Ah Choi, Min Jung Kim, Kichul Shin, Hyun-Ok Kim, Sung Won Lee, Joong Kyong Ahn, Chang Hoon Lee, Se Hee Kim, Kyeong Min Son, Ki Won Moon, Chang-Nam Son. The Journal of Rheumatology Dec 2025, jrheum.2025-0881; DOI: 10.3899/jrheum.2025-0881
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