Baseline urate level and renal function predict outcomes of urate-lowering therapy using low doses of febuxostat and benzbromarone: a prospective, ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-09-02

AUTHORS

Nan Liang, Mingshu Sun, Ruixia Sun, Ting Xu, Lingling Cui, Can Wang, Lidan Ma, Xiaoyu Cheng, Xiaomei Xue, Wenyan Sun, Xuan Yuan, Hui Zhang, Hailong Li, Yuwei He, Aichang Ji, Xinjiang Wu, Changgui Li

ABSTRACT

BackgroundLow doses of febuxostat or benzbromarone are widely used in Asian countries, but lacking studies to compare the efficacy and safety of the two urate-lowering drugs.MethodsTo compare the efficacy and safety of low-dose febuxostat with low-dose benzbromarone in patients with primary gout, a randomized controlled, open-label trial was performed among male patients with primary gout for urate-lowering therapy (ULT) in a dedicated gout clinic in China. Randomization was carried out by a third-party institution according to random number table. Patients were randomly assigned 1:1 to febuxostat group (Feb group) (20 mg daily) or benzbromarone group (Ben group) (25 mg daily) and treated for 12 weeks. General information and biochemical data were collected at baseline and at every visit monthly. Clinical characteristics before and after the ULT were analyzed in the two groups by SPSS and EmpowerStats software.ResultsTwo hundred forty patients were enrolled and randomized in the two groups, with 214 patients completing 12 weeks’ ULT (105 in the Feb group and 109 in the Ben group). After 12 weeks, substantial percentages of patients in both Feb and Ben group achieved the target serum uric acid (sUA) (< 360 μmol/L) and serum urate levels were reduced significantly for both groups (Feb 39.5% and 156.83 μmol/L vs. Ben 35.7% and 163.99 μmol/L). Multivariate analysis suggests baseline sUA level and renal function were associated with the outcome of the rate of achieving target sUA (RAT). Sub-group analysis suggests low doses of febuxostat and benzbromarone rendered better RAT for patients with sUA < 540 μmol/L and creatinine clearance rate (Ccr) ≤ 110 mL min−1 1.73 m−2 at baseline. The drugs were well tolerated, and the incidence of gout flares in Feb group was similar with that in Ben group (22.85% vs. 33.94%).ConclusionOverall, febuxostat 20 mg daily and benzbromarone 25 mg daily reduced sUA, and gout patients with sUA level < 540 μmol/L or Ccr ≤ 110 mL min−1 1.73 m−2 at baseline had better chance to achieve target uric acid levels. The current study suggests sUA level and renal function are key factors to consider when recommending low doses of febuxostat and benzbromarone to gout patients.Trial registrationRegistered with ChiCTR, No. ChiCTR1800019352 (retrospectively registered). More... »

PAGES

200

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13075-019-1976-x

DOI

http://dx.doi.org/10.1186/s13075-019-1976-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1120775269

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31477161


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365 Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
366 The Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
367 schema:name Department of Rheumatology and Clinical Immunology, the Affiliated Hospital of Qingdao University, Qingdao, China
368 Qingdao University, Qingdao, China
369 Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
370 The Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
371 rdf:type schema:Organization
 




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