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Febuxostat CKD

Samir G Mallat, Sahar Al Kattar, Bassem Y Tanios, Abdo Jurjus
Uric acid is a product of purine metabolism and has been linked to gout and kidney calculi. Chronic kidney disease (CKD) and hypertension (HTN) are two major public health problems, and both are associated with increased risk of cardiovascular events. Emerging evidence suggests a pathogenic role of hyperuricemia in the development of HTN and CKD, in addition to progression of CKD, by inducing renal inflammation, endothelial dysfunction, and activation of the renin-angiotensin system. In addition, several epidemiological studies have linked hyperuricemia with an increased risk of HTN and CKD...
October 2016: Current Hypertension Reports
Ghaith Mitri, Eric T Wittbrodt, Robin S Turpin, Beni A Tidwell, Kathy L Schulman
BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk for developing gout and having refractory disease. Gout flare prevention relies heavily on urate-lowering therapies such as allopurinol and febuxostat, but clinical decision making in patients with moderate-to-severe CKD is complicated by significant comorbidity and the scarcity of real-world cost-effectiveness studies. OBJECTIVE: To compare total and disease-specific health care expenditures by line of therapy in allopurinol and febuxostat initiators after diagnosis with gout and moderate-to-severe CKD...
April 2016: Journal of Managed Care & Specialty Pharmacy
Lee J Smolen, James C Gahn, Ghaith Mitri, Aki Shiozawa
OBJECTIVE: To determine the cost-effectiveness of febuxostat vs allopurinol for the management of gout. METHODS: A stochastic microsimulation cost-effectiveness model with a US private-payer perspective and 5-year time horizon was developed. Model flow based on guideline and real-world treatment paradigms incorporated gout flare, serum uric acid (sUA) testing, treatment titration, discontinuation, and adverse events, chronic kidney disease (CKD) incidence and progression, and type 2 diabetes mellitus (T2DM) incidence...
2016: Journal of Medical Economics
Dipankar Sircar, Soumya Chatterjee, Rajesh Waikhom, Vishal Golay, Arpita Raychaudhury, Suparna Chatterjee, Rajendra Pandey
BACKGROUND: Hyperuricemia is a putative risk factor for the progression of chronic kidney disease (CKD). We hypothesized that control of asymptomatic hyperuricemia may slow disease progression in CKD. STUDY DESIGN: This was a single-center, double-blind, randomized, parallel-group, placebo-controlled study. SETTING & PARTICIPANTS: Eligible participants were adults from Eastern India aged 18 to 65 years with CKD stages 3 and 4, with asymptomatic hyperuricemia...
December 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kenichi Tanaka, Masaaki Nakayama, Makoto Kanno, Hiroshi Kimura, Kimio Watanabe, Yoshihiro Tani, Yoshimitsu Hayashi, Koichi Asahi, Hiroyuki Terawaki, Tsuyoshi Watanabe
BACKGROUND: Hyperuricemia is associated with the onset of chronic kidney disease (CKD) and renal disease progression. Febuxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has been reported to have a stronger effect on hyperuricemia than conventional therapy with allopurinol. However, few data are available regarding the clinical effect of febuxostat in patients with CKD. METHODS: A prospective, randomized, open-label, parallel-group trial was conducted in hyperuricemic patients with stage 3 CKD...
December 2015: Clinical and Experimental Nephrology
Akira Sezai, Masayoshi Soma, Kin-ichi Nakata, Shunji Osaka, Yusuke Ishii, Hiroko Yaoita, Hiroaki Hata, Motomi Shiono
BACKGROUND: The NU-FLASH trial demonstrated that febuxostat was more effective for hyperuricemia than allopurinol. This time, we compared these medications in patients with chronic kidney disease (CKD) from the NU-FLASH trial. METHODS AND RESULTS: In the NU-FLASH trial, 141 cardiac surgery patients with hyperuricemia were randomized to a febuxostat group or an allopurinol group. This study analyzed 109 patients with an estimated glomerular filtration rate (eGFR) ≤60 mL/min/1...
October 2015: Journal of Cardiology
Tetsu Akimoto, Yoshiyuki Morishita, Chiharu Ito, Osamu Iimura, Sadao Tsunematsu, Yuko Watanabe, Eiji Kusano, Daisuke Nagata
Febuxostat is a nonpurine xanthine oxidase (XO) inhibitor, which recently received marketing approval. However, information regarding the experience with this agent among advanced chronic kidney disease (CKD) patients is limited. In the current study, we investigated the effects of oral febuxostat in patients with advanced CKD with asymptomatic hyperuricemia. We demonstrated, for the first time, that not only the serum levels of uric acid (UA) but also those of 8-hydroxydeoxyguanosine, an oxidative stress marker, were significantly reduced after six months of febuxostat treatment, with no adverse events...
2014: Drug Target Insights
Yuki Tsuruta, Toshio Mochizuki, Takahito Moriyama, Mitsuyo Itabashi, Takashi Takei, Ken Tsuchiya, Kosaku Nitta
Hyperuricemia is a frequent complication of chronic kidney disease (CKD). Febuxostat is a novel xanthine oxidase inhibitor that is metabolized by many metabolic pathways in the kidney and the liver. We performed a 1-year cohort study of 73 hyperuricemic patients who had an estimated glomerular filtration rate (eGFR) below 45 ml/min and were being treated with urate-lowering therapy. In 51 patients, treatment was changed from allopurinol to febuxostat, and the other 22 patients were continued on allopurinol...
November 2014: Clinical Rheumatology
Yugo Shibagaki, Iwao Ohno, Tatsuo Hosoya, Kenjiro Kimura
Hyperuricemia (HU) is common in patients with chronic kidney disease (CKD), and accumulating evidence suggests it has a pathogenic role in the progression of the disease. However, a major challenge in treating patients with HU is the adverse effects caused by urate-lowering drugs used to treat CKD. Because of these untoward effects, doses need to be reduced, which leads to suboptimal efficacy. Febuxostat has been shown to be highly efficacious in reducing serum uric acid (sUA) and is well tolerated in patients with mild kidney dysfunction...
October 2014: Hypertension Research: Official Journal of the Japanese Society of Hypertension
K H K Patel, D J A Goldsmith
Patients with cardiac morbidity are known to have increased risk of developing renal disease, and vice versa. Cardiorenal syndrome is a general term describing concomitant cardiac and renal dysfunction, and recently there has been renewed interest in the role of uric acid (UA) in its pathophysiology and management. There is evidence to suggest that UA-lowering drugs, such as the xanthine oxidase (XO) inhibitors allopurinol and Febuxostat, may not only retard deteriorating renal function in the context of chronic kidney disease (CKD) but also confer protective cardiovascular effects...
July 2014: International Journal of Clinical Practice
Y Kang, M J Kim, H N Jang, E J Bae, S Yun, H S Cho, S-H Chang, D J Park
WHAT IS KNOWN AND OBJECTIVE: Febuxostat is now recommended as the first-line pharmacological urate-lowering therapy for gout in the American College of Rheumatology guidelines. There is no case of rhabdomyolysis associated with febuxostat among reported side effects of the drug. Our objective is to report on a case of rhabdomyolysis associated with initiation of febuxostat in a patient with chronic kidney disease (CKD). CASE SUMMARY: A 73-year-old male patient visited our emergency room due to progressive weakness in both lower extremities starting 3 days earlier...
June 2014: Journal of Clinical Pharmacy and Therapeutics
Tatsuo Hosoya, Kenjiro Kimura, Sadayoshi Itoh, Masaaki Inaba, Shunya Uchida, Yasuhiko Tomino, Hirofumi Makino, Seiichi Matsuo, Tetsuya Yamamoto, Iwao Ohno, Yugo Shibagaki, Satoshi Iimuro, Naohiko Imai, Masanari Kuwabara, Hiroshi Hayakawa
BACKGROUND: Hyperuricemia is a risk factor for the onset of chronic kidney disease (CKD) and is significantly associated with the progression of CKD. However, there is no sufficient evidence by interventional research supporting a cause-effect relationship. Hyperuricemic patients without gouty arthritis, whose serum urate (SUA) concentration is ≥8.0 mg/dL and who have a complication, are treated by pharmacotherapy in addition to lifestyle guidance. Nevertheless, there is no evidence that rationalizes pharmacotherapy for patients with hyperuricemia who have no complication and whose SUA concentration is below 9...
2014: Trials
Yukinao Sakai, Tomoyuki Otsuka, Dai Ohno, Tsuneo Murasawa, Naoki Sato, Shuichi Tsuruoka
BACKGROUND: Availability of the novel xanthine oxidase inhibitor febuxostat, which has multiple excretion pathways, enables investigation of the significance of serum uric acid control on renal function in patients with chronic kidney disease (CKD). METHODS: This was an exploratory, retrospective, observational study conducted at a single Japanese center. Serum uric acid concentrations and serum creatinine levels in the 6 months before and after the start of febuxostat treatment were collected for CKD patients switched from allopurinol after failing to achieve serum uric acid concentrations ≤6...
March 2014: Renal Failure
S Kobayashi, M Ogura, T Hosoya
WHAT IS KNOWN AND OBJECTIVE: Febuxostat is a new non-purine selective inhibitor of xanthine oxidase for the treatment of hyperuricaemia in patients with gout. Febuxostat is recommended as the first-line pharmacologic urate-lowering therapy for gout in the American College of Rheumatology guidelines. Febuxostat has not been reported to cause severe complications, especially haematological abnormalities. Our objective is to report two cases of neutropenia associated with initiation of febuxostat therapy for hyperuricaemia in patients with chronic kidney disease (CKD)...
June 2013: Journal of Clinical Pharmacy and Therapeutics
Abdul A Abdellatif, Naser Elkhalili
Chronic kidney disease (CKD) is a comorbid condition that affects, based on recent estimates, between 47% and 54% of patients with gouty arthritis. However, data from randomized controlled trials in patients with gouty arthritis and CKD are limited, and current gouty arthritis treatment guidelines do not address the challenges associated with managing this patient population. Nonsteroidal anti-inflammatory drugs and colchicine are recommended first-line treatments for acute gouty arthritis attacks. However, in patients with CKD, nonsteroidal anti-inflammatory drugs are not recommended because their use can exacerbate or cause acute kidney injury...
November 2014: American Journal of Therapeutics
Rodolfo V Curiel, Nicolas J Guzman
OBJECTIVE: As many as half of all patients with gouty arthritis have some degree of renal impairment. The goal of this systematic review is to provide physicians with a comprehensive examination of available data on the risks and benefits of gouty arthritis treatment options when used in patients with chronic kidney disease (CKD). METHODS: We conducted a systematic literature review to determine what information is available to guide treatment decisions in this patient population...
October 2012: Seminars in Arthritis and Rheumatism
Hiroki Omori, Noritaka Kawada, Kazunori Inoue, Yoshiyasu Ueda, Ryohei Yamamoto, Isao Matsui, Jyunya Kaimori, Yoshitsugu Takabatake, Toshiki Moriyama, Yoshitaka Isaka, Hiromi Rakugi
BACKGROUND: Renal interstitial fibrosis is the common pathway in progressive renal diseases, where oxidative stress promotes inflammation and macrophage infiltration. Febuxostat is a novel nonpurine xanthine oxidase (XO)-specific inhibitor for treating hyperuricemia. While some reports suggest a relationship between hyperuricemia and chronic kidney disease (CKD), the renoprotective mechanism of an XO inhibitor in CKD remains unknown. Recent reports have focused on XO as a source of oxidative stress...
August 2012: Clinical and Experimental Nephrology
Rajendra K Marwah
BACKGROUND: Gouty arthritis is increasing in prevalence in men and women, particularly in older age groups. METHODS: A PubMed search was conducted to identify common comorbidities associated with gouty arthritis, their impact on quality of life, and strategies to manage gouty arthritis and its associated comorbidities. RESULTS: Gouty arthritis is associated with numerous comorbidities that are increasing in prevalence (chronic kidney disease [CKD], hypertension, obesity, diabetes, metabolic syndrome, and cardiovascular disease) and that negatively impact long-term prognosis and quality of life...
December 2011: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
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