Abstract
BackgroundFebuxostat is a novel xanthine oxidase inhibitor. However, few studies have examined the long-term efficacy and tolerability of febuxostat after switching from allopurinol in hemodialysis (HD) patients. Therefore, the present study evaluated the long-term efficacy and tolerability of febuxostat in HD patients after switching from allopurinol.FindingsWe monitored the levels of hemoglobin, hematocrit, platelet count, blood urea nitrogen, serum creatinine, serum sodium, serum potassium, serum chloride, serum calcium, serum inorganic phosphorus, aspartate transaminase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, and total protein that were considered overall as a tolerability index, while the serum uric acid (UA) level was considered an index of efficacy. All values were measured at baseline and at 1, 6, 12, and 16 months after the switch to febuxostat therapy. All subjects switched from allopurinol (100 mg/day) to febuxostat (10 mg/day) in August 2013. Clinical laboratory data were collected at baseline in July 2013 until December 2014. Nine patients were included in the study analysis. Results showed that clinical laboratory data at baseline versus those at 16 months were not significantly different. Serum UA levels, which represented the efficacy index, were significantly different between the baseline level (6.8 ± 1.4) and those at 1, 6, 12, and 16 months (5.2 ± 1.1, 5.1 ± 1.1, 4.6 ± 0.9, and 5.4 ± 1.8 mg/dL, respectively; all p < 0.05).ConclusionSwitching from allopurinol to febuxostat in HD patients reduced serum UA levels, with no changes in other clinical laboratory data in the long term.
Highlights
Febuxostat is a novel xanthine oxidase inhibitor
Hyperuricemia is known to be associated with hypertension, vascular disease, chronic kidney disease (CKD), and cardiovascular disease (CVD) [1]
CVD is associated with a risk of morbidity and mortality in hemodialysis (HD) patients [2], and CKD patients receiving uratelowering therapy are mainly treated with xanthine oxidase (XO) inhibitors [3]
Summary
Hyperuricemia is known to be associated with hypertension, vascular disease, chronic kidney disease (CKD), and cardiovascular disease (CVD) [1]. CVD is associated with a risk of morbidity and mortality in hemodialysis (HD) patients [2], and CKD patients receiving uratelowering therapy are mainly treated with xanthine oxidase (XO) inhibitors [3]. In HD patients, febuxostat therapy lowered serum UA levels significantly after 6 months [8]. In CKD patients, switching from allopurinol to febuxostat significantly decreased serum UA levels after 12 months [9]. To date, few studies have examined the long-term efficacy and tolerability of febuxostat when switching from allopurinol in HD patients. Side effects of febuxostat therapy for hyperuricemia in CKD patients have been. In this study we evaluated the long-term efficacy and tolerability of febuxostat in HD patients after switching from allopurinol
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