Comparison of Allopurinol And Febuxostat in Asymptomatic Hyperuricemic Patients and their Impact on Serum Creatinine

Authors

  • Tafazzul Hussain
  • Musarrat Sultana
  • Syeda Amber Zaidi
  • Syed Saud Hasan
  • Mohsin Turab
  • Shamaila Khalid

DOI:

https://doi.org/10.51985/JBUMDC2019070.

Keywords:

Allopurinol, Febuxostat, Serum uric acid, Serum creatinine.

Abstract

Objective: To determine the effect of Allopurinol & Febuxostat for the treatment of hyperuricemic patients & its influence
on renal function by measuring serum creatinine level.
Study Design & setting: The clinical trial was conducted at Dr. Ruth K M Pfau Civil Hospital, Karachi, during the period
of September 2018 to March 2019
Methodology: 60 patients with sUA > 6.8 mg/dl were registered. A detailed history was taken, patient's baseline serum
Uric Acid (sUA) & serum Creatinine were measured. Patients were divided into two groups to receive Allopurinol, 300
mg & Febuxostat 80 mg, daily for 90-days. The blood parameters were repeated at day 30 and 90.
Results: Group-A (Allopurinol treated patients) baseline uric acid changed from mean 8.79 ± 0.98 mg/dl to 6.40 ± 0.86
mg/dl at day 90. In Group-B (Febuxostat treated patients) sUA baseline mean changed from 8.85 ± 0.97 mg/dl to 5.96 ±
0.68 mg/dl. Mean difference ± SD change of serum uric acid in Group-A was 2.39 ± 1.15 mg/dl and with Group-B it was
2.90 ± 0.87 mg/dl. Mean Serum Creatinine in Group-A changed from 1.54 ± 0.39 mg/dl to mean 1.48 ± 0.40 mg/dl compared
with Group-B where it changed from 1.42 ± 0.30 mg/dl to 1.45 ± 0.31 mg/dl at day-90. Mean difference ± SD of serum
Creatinine in Group-A was 0.11 ± 0.25 mg/dl & in Group-B it was, 0.03 ± 0.15 mg/dl. The above changes were statistically
non-significant with p-value of 0.144.
Conclusion: Allopurinol and Febuxostat treatment resulted in improvement of serum Uric Acid levels while maintaining
their renal function.

References

Smith EU, Diaz-Torne C, Perez-Ruiz F, March LM.

Epidemiology of gout: an update. Best Pract Res Clin

Rheumatol. 2010; 24:811–27

Stamp L, Dalbeth N. Urate-lowering therapy for asymptomatic

hyperuricemia: a need for caution. Semin Arthritis Rheum.

; 46:457–64.

Kang DH, Chen W. Uric acid and chronic kidney disease:

new understanding of an old problem. Semin Nephrol. 2011;

(5):447–52.

Jin M & Yang F. Uric acid, hyperuricemia and vascular

diseases, Front Biosci. 2012; 17: 656–669.

Siu YP, Leung KT, Tong MK, Kwan TH. Use of allopurinol

in slowing the progression of renal disease through its ability

to lower serum uric acid level. Am J Kidney Dis. 2006;

:51–59

Kang DH, Nakagawa T, Feng L, Watanabe S, et al. A role for

uric acid in the progression of renal disease. J Am Soc Nephrol.

; 13: 2888–2897.

Aung T, Myung G, FitzGerald JD. Treatment approaches and

adherence to urate-lowering therapy for patients with gout.

Patient Prefer Adherence 2017; 11:795–800.

Richette P, Doherty M, Pascual E, Barskova V, et al. 2016

updated EULAR evidence-based recommendations for the

management of gout. Ann Rheum Dis. 2017; 76:29–42.

Becker MA, Kisicki J, Khosravan R. Febuxostat (TMX-67),

a novel, non-purine, selective inhibitor of xanthine oxidase,

is safe and decreases serum urate in healthy volunteers.

Nucleosides Nucleotides Nucleic Acids 2004; 23:1111–16.

Kanwar G and Kabra, R. Serum uric acid level and obesity:

An association. International Journal of healthcare Sciences.

; 4(1):52–55.Kuo CF, Grainge MJ, Zhang W, Doherty M. Global

epidemiology of gout: prevalence, incidence and risk factors.

Nat Rev Rheumatol 2015;11 (11):649–62.

Ling Qiu, Xin-qi, Cheng Jie Wu, Jun-ting Liu. Prevalence of

hyperuricemia and its related risk factors in healthy adults

from Northern and Northeastern Chinese provinces. . 2013;

: 664-72

Stack A, Manolis AJ, Ritz E. Detrimental role of hyperuricemia

on the cardio-Reno vascular system. Curr Med Res Opin.

(Sep); 31 (Suppl 2):21-6.

Becker MA, Schumacher HR Jr, Wortmann RL. Febuxostat

compared with allopurinol in patients with hyperuricemia and

gout, N Engl J Med. 2005; 353: 2450-61.

Day RO, Graham GG, Hicks M, McLachlan AJ, Stocker SL,

Williams KM. Clinical pharmacokinetics and

pharmacodynamics of allopurinol and oxypurinol. Clin

Pharmacokinet. 2007; 46:623–644

Whelton A, Macdonald PA, Zhao L, Hunt B, Gunawardhana

L. Renal function in gout: long-term treatment effects of

febuxostat. J Clin Rheumatol. 2011;17: 7–13.

Kanbay M, Ozkara A, Selcoki Y, Isik B, Turgut F, Bavbek N,

et al. Effect of treatment of hyperuricemia with allopurinol

on blood pressure, creatinine clearance, and proteinuria in

patients with normal renal functions. Int Urol Nephrol.

;39:1227–33

Perez-Ruiz F, Alonso-Ruiz A, Calabozo M, Herrero-Beites

A, et al. Efficacy of allopurinol and benzbromarone for the

control of hyperuricaemia: a pathogenic approach to the

treatment of primary chronic gout. Ann Rheum Dis 1998; 57:

–9.

Grassi D, Pontremoli R, Bocale R, Ferri C and Desideri G:

Therapeutic approaches to chronic hyperuricemia and gout.

High Blood Press Cardiovasc Prev. 2014. 21:243–250.

Borghi C, Perez-Ruiz F. Urate lowering therapies in the

treatment of gout: a systematic review and meta-analysis.

Mar; 20 (5):983-92.

Schumacher HR Jr, Becker MA, Wortmann RL, et al. Effects

of Febuxostat versus allopurinol and placebo in reducing

serum urate in subjects with hyperuricemia and gout: a 28-

week, phase III, randomized, double-blind, parallel-group

trial. Arthritis Rheum. 2008; 59: 1540-8.

Michael A, Becker H, Ralph Schumacher Jr, Robert L,

Wortmann, Patricia A. Febuxostat Compared with Allopurinol

in Patients with Hyperuricemia and Gout. Engl J Med 2005;

:2450-61

Kamatani N, Fujimori N, Hada T. An Allopurinol-Controlled,

Randomized, Double-Dummy, Double-Blind, Parallel

Between-Group, Comparative Study of Febuxostat (TMX-

, a Non-Purine-Selective Inhibitor of Xanthine Oxidase,

in Patients with Hyperuricemia Including Those with Gout

in Japan: Phase 3 Clinical Study Journal of Clinical

Rheumatology. 2011;17(4): S13-S18.

Becker MA, Schumacher HR, Espinoza LR, Wells AF,

MacDonald P, Lloyd E, et al. The urate-lowering efficacy and

safety of Febuxostat in the treatment of the hyperuricemia of

gout: The CONFIRMS trial. 2010; 12 (2):R63

Frampton, JE. Febuxostat: a review of its use in the treatment

of hyperuricemia in patients with gout. Drugs. 2015; 75

(4):427-38.

Downloads

Published

2020-03-17

How to Cite

Hussain, T. ., Sultana, M. ., Zaidi, S. A. ., Hasan, S. S., Turab, M. ., & Khalid, S. . (2020). Comparison of Allopurinol And Febuxostat in Asymptomatic Hyperuricemic Patients and their Impact on Serum Creatinine. Journal of Bahria University Medical and Dental College, 10(1), 17–21. https://doi.org/10.51985/JBUMDC2019070.

Issue

Section

Original Articles