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Effects of topiroxostat in hyperuricemic patients with chronic kidney disease
Taro Horino1, Yutaka Hatakeyama2, Osamu Ichii3
1Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan. horinott@yahoo.co.jp.
Background:
Hyperuricemia is associated with chronic kidney disease (CKD). Although topiroxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has a strong effect against hyperuricemia, limited data are available on its renoprotective effect against CKD.
Methods:
This study was conducted between October 2014 and May 2016. Thirty patients (20 male, 10 female) were administered 40 mg/day of topiroxostat twice daily. All patients were followed for a year. To elucidate the effects of topiroxostat, we evaluated the clinically documented primary indication of progression, viz. laboratory evidence of kidney function decline (reference indicator), uric acid, and hypertension in different patient groups, separated according to their baseline uProt levels and baseline eGFR.
Results:
Topiroxostat treatment resulted in significant reduction in SUA (-1.53 mg/dL), systolic blood pressure (-8.9 mmHg), diastolic blood pressure (-5.0 mmHg), and urinary protein excretion (-795.5 mg/gCr) compared with baseline values. However, serum creatinine and urinary NAG levels, and estimated glomerular filtration rate did not change significantly.
Conclusions:
Topiroxostat reduced SUA levels effectively and may exhibit renoprotective effect in hyperuricemic patients with CKD. Further studies are required to clarify whether topiroxostat prevents the progression of renal disease and improves the prognosis of CKD patients.
Insights
Topiroxostat effectively lowers uric acid and blood pressure in patients with chronic kidney disease (CKD). While not significantly improving kidney function markers, it shows potential renoprotective effects in hyperuricemic individuals.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Hyperuricemia is a known risk factor for chronic kidney disease (CKD).
- Topiroxostat, a selective xanthine oxidase inhibitor, effectively manages hyperuricemia.
- Limited data exist on topiroxostat's renoprotective potential in CKD patients.
Purpose of the Study:
- To evaluate the renoprotective effects of topiroxostat in patients with hyperuricemia and CKD.
- To assess the impact of topiroxostat on uric acid levels, blood pressure, and kidney function markers.
Main Methods:
- A one-year study involving 30 patients with hyperuricemia and CKD.
- Patients received 40 mg of topiroxostat twice daily.
- Evaluated changes in serum uric acid, blood pressure, urinary protein, serum creatinine, and estimated glomerular filtration rate (eGFR).
Main Results:
- Topiroxostat significantly reduced serum uric acid (SUA) by -1.53 mg/dL.
- Significant reductions were observed in systolic (-8.9 mmHg) and diastolic (-5.0 mmHg) blood pressure.
- Urinary protein excretion decreased significantly by -795.5 mg/gCr, but serum creatinine and eGFR showed no significant changes.
Conclusions:
- Topiroxostat effectively lowers SUA levels in hyperuricemic CKD patients.
- The drug may offer renoprotective benefits, evidenced by reduced proteinuria.
- Further research is needed to confirm topiroxostat's role in preventing CKD progression and improving patient outcomes.
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