Abstract 9432: Febuxostat -A Xanthine Oxidase Inhibitor- May Improve Cardiorenal Interaction: A Randomized Controlled Pilot Study
Introduction: There is growing evidence of an association between high uric acid (UA) levels and cardiovascular disease. However, little data is available about the mechanism by which UA metabolism affects cardiorenal interaction, which leads to cardiovascular disease. Febuxostat, a selective xanthine oxidase inhibitor, was approved in 2012 in Japan not only for the treatment of patients with only gout, but also for those with only hyperuricemia.
Hypothesis: We hypothesized that febuxostat might modify cardiorenal interactions by suppressing the renin-aldosterone system and improving the renal function in hypertensive hyperuricemic patients.
Methods: We conducted a 6-month, prospective, randomized, open-label study in which we classified hypertensive hyperuricemic patients to either a febuxostat group (n = 30) or a control group (n = 30). The serum UA level of the patients was monitored, and the dose of febuxostat was adjusted to maintain the serum UA level < 6.0 mg/dL.
Results: In the febuxostat group, the plasma renin activity (PRA), plasma aldosterone concentration (PAC), and serum UA level significantly decreased by 33% (p < 0.05), 14% (p < 0.05), and 23% (p < 0.0001), respectively. The estimated glomerular filtration rate (eGFR) was significantly increased by 6.0% (p < 0.05). None of these changes was observed in the control group. Furthermore, a significant correlation was observed between the change in the serum UA level, and the changes in the PRA (r = 0.292, p = 0.036), PAC (r = 0.350, p = 0.011), serum creatinine level (r = 0413, p = 0.002), and eGFR (r = -0.499, p = 0.0002).
Conclusions: These results support the hypothesis that febuxostat might not only reduce serum UA level, but also improve cardiorenal interaction. These preliminary findings require confirmation in larger clinical trials.
Author Disclosures: S. Tani: None. A. Takahashi: None. K. Nagao: None. A. Hirayama: None.
- © 2014 by American Heart Association, Inc.