Efficacy and safety of febuxostat on type 2 diabetic nephropathy complicated with hyperuricemia

Abstract

Objective To evaluate the efficacy and safety of febuxostat in the treatment of type 2 diabetic nephropathy complicated with hyperuricemia. Methods A total of 153 patients with type 2 diabetic nephropathy complicated with hyperuricemia treated in hospital from November 2016 to April 2018 were selected. According to the random number table method, the patients were divided into allopurinol group, benzbromarone group and febuxostat group. There were 51 patients in each group. All of the patients underwent conventional hypoglycemic regimens, low-purine diets, and diabetes health education. On this basis, allopurinol, benzbromarone, and febutustal tablets were given orally to patients with allopurinol, benzbromarone, and budesta. The total effective rate of the three groups of patients was compared with the indexes of blood urea nitrogen (BUN), serum creatinine (Scr) and serum uric acid (SUA) before treatment, 4 weeks, and 12 weeks of treatment were compared. The patient’s adverse reactions were observed. Results The total effective rates of allopurinol group, benzbromarone group, and febuxostat group were 72.5%, 88.2%, and 88.2%, respectively. Compared with the allopurinol group, the total efficiency was significantly higher in the benzbromarone group and the febuxostat group (P all<0.05). After 4 weeks of treatment, the SUA levels of the three groups were significantly lower than those before treatment (P all<0.05). After 12 weeks of treatment, the SUA levels of the three groups were significantly lower than those treated for four weeks and before treatment (P all<0.05). After 12 weeks of treatment, the SUA levels of the benzbromarone group and the febuxostat group were significantly lower than that of the allopurinol group (P all<0.05). The Scr level in the benzbromarone group was significantly higher than before treatment (all P<0.05). The Scr levels in the allopurinol group and the febuxostat group were significantly lower than those before treatment (all P<0.05). Compared with the febuxostat group (11.8%, 5/51), the incidence of adverse reactions was significantly higher in the allopurinol group (25.5%, 15/51) and benzbromarone group (23.5%, 14/51) (χ2=6.220, 5.239, P=0.019, 0.022). Conclusions Febuxostat is more effective than allopurinol on improving type 2 diabetic nephropathy complicated with hyperuricemia. Besides, the incidence of renal function deterioration, rash and other adverse reactions is lower, and the safety is high. It is worthy of clinical application. Key words: Febuxostat; Diabetic nephropathy; Hyperuricemia