Efficacy of xanthine oxidase inhibitor for chronic kidney disease patients with hyperuricemia


Hiroshi Matsuo 1, Eiji Ishikawa 2, Hirofumi Machida 3, Yasuhide Mizutani 4, Akiko Tanoue 1 5, Takahiro Ohnishi 6, Tomohiro Murata 7, Shinya Okamoto 1, Toru Ogura 8, Yuki Nishimura 8, Hiroo Ito 9, Masashi Yasutomi 10, Kan Katayama 7, Shinsuke Nomura 1, Masaaki Ito 7

Main idea: In this study, xanthine oxidase inhibitors did not significantly reduce the uPCR in chronic kidney disease stage 3 and 4 patients with hyperuricemia.


Background: Hyperuricemia is a known risk factor for end-stage renal disease. Although xanthine oxidase (XO) inhibitors are expected to protect kidney function, evidence to this end is insufficient at present.

Methods: This study was a multi-center, open-labeled, randomized study conducted in Mie Prefecture in Japan. Patients were included if they were between 20 and 80 years old and had a serum uric acid (sUA) level of 7.0 mg/dl. Patients randomly assigned to a Topiroxostat or Febuxostat group. The primary outcome was the change in the uPCR after 24 weeks.

Results: The change in the median uPCR after 24 weeks was not statistically significant after treatment in the Topiroxostat or Febuxostat group. The sUA levels decreased significantly in both groups. No significant change in eGFR was noted in either of the treatment groups. The study was published in the European Journal of Clinical Pharmacology and Neuroendocrinology, volume 2 (April 2014).


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