The Allopurinol and Febuxostat in the Treatment of Hyperuricemic Patients and Their Impact on Lipid Fractions (Cholesterol, LDL, HDL)

Abstract

Little is known about the role of serum uric acid and its impact on lipid fraction. The associations between hyperuricemia and much co-morbidity such as dyslipidemia and others are well recognized. This study aims to explore the impact of Allopurinol & Febuxostat on the serum lipid levels in hyperuricemia patients. An interventional clinical study was conducted in Medical OPD, Civil Hospital Karachi. The study period was six months, from September 2018 to March 2019. In this clinical trial, after ERC approval, 70 enrolled patients, 60 registered patients of serum uric acid sUA>6.8 mg/dl, after inclusion and exclusion criteria and written consent, detailed history on pro forma and patients were divided into two groups, one to receive allopurinol, 300 mg & second Febuxostat 80 mg, daily for 90-days. Patients' uric acid, cholesterol, LDL, HDL, serum creatinine, alkaline phosphatase, SGOT, and blood sugar for safety profile from baseline, repeated at day 30, 60, and 90, keep in the case record file, on follow-up visits for final analysis. Group-A (Allopurinol treated patients) baseline uric acid was changed from mean 8.79 ± 0.98 to 6.40 ± 0.86, cholesterol 195 ± 30 to 198 ± 31, LDL135 ± 20 to 137 ± 20 & HDL31 ± 07 to 31 ± 06 at day 90. Group-B (Febuxostat treated) sUA mean was 8.85 ± 0.97 to 5.96 ± 0.68, cholesterol 176 ± 36 to 164 ± 25, LDL 129 ± 09 to 124 ± 09, HDL 29 ± 06 to 36 ± 06. Mean difference ± SD change in group A & B of sUA 2.39 ± 1.15 & 2.90 ± 0.87, cholesterol - 2.90 ± 4.10 & 12.43 ± 20.76 with p-value < 0.001, LDL - 2.53 ± 6.97 & 4.63 ± 5.05 with p-value < 0.001, HDL 0.20 ± 05.87 & -7.50 ± 2.58 with p-value < 0.001. Febuxostat lowers sUA and reduces cholesterol & LDL but increases HDL, while allopurinol does not impact lipid fractions. Urate lowering drugs interventions change the risk factors and offer a practical and cheap approach to hyperlipidemia and reduce cardiovascular risk.