Efficacy and safety of urate-lowering therapy in multimorbid patients in real clinical practice: results of clinical study

Abstract

Background. Clinical studies of urate-lowering therapy (ULT) use in multimorbid patients, including those with chronic kidney disease (CKD), are important in modern medical science. The purpose was to determine the efficacy and safety of ULT in patients with hyperuricemia and comorbid conditions, including people with chronic kidney disease, in real clinical practice. Materials and methods. This prospective comparative clinical study “Liquestia: comparative efficacy and safety in gouty arthritis patients with comorbid diseases and in patients with hyperuricemia and chronic kidney disease” was conducted in real clinical practice with the involvement of 124 patients with hyperuricemia, who were prescribed either febuxostat (Liquestia, JSC “Farmak”/Adenuric, Berlin Chemie) or allopurinol as ULT. Results. Individuals who received febuxostat significantly more often and faster reached the target levels of uric acid compared to patients who underwent treatment by allopurinol, regardless of glomerular filtration rate (GFR), except those from dialysis subgroup, and the presence of comorbidities. Patients in febuxostat subgroups during the study showed an increase in GFR after 6 months of treatment — at the level of the trend in the group with baseline GFR ≥ 60 ml/min and at a statistically significant level — in CKD stage 3–4, which could be the evidence of renoprotective effect of febuxostat with reduced GFR, while people receiving allopurinol tended to further decrease of GFR in 31.8 % of cases. Conclusions. The use of Liquestia for the treatment of patients with hyperuricemia and various comorbid conditions is no less effective than the use of Adenuric and more effective than allopurinol and helps achieve the target levels of uric acid in 90 % of cases within 6 months of treatment, which accompanied by a statistically significant increase in GFR in patients with CKD stage 3–4.