MANAGEMENT OF RENAL FAILURE IN THE CONTEXT OF HYPERURICEMIC HEART DISEASE THROUGH DRUG METABOLISM: A COMPARATIVE ANALYSIS OF FEBUXOSTAT AND TOPIROXOSTAT
Keywords:
TROFEO study, hyperuricemia, chronic kidney failure, xanthine oxidase-reductase inhibitors, febuxostat, topiroxostat, uric acidAbstract
Hyperuricemia is one of the major risk factors for the development of chronic kidney failure and aggravates its progression. In this sub-analytical TROFEO study investigating chronic kidney failure, patients with hyperuricemia who underwent cardiovascular surgery and had an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m² were selected, and the effects of two xanthine oxidase enzyme inhibitors — febuxostat and topiroxostat — were compared. Forty-two patients were treated with febuxostat and thirty-nine with topiroxostat. The primary outcome of the study was the serum uric acid level, which febuxostat maintained below the clinically relevant threshold of 6.0 mg/dL. Secondary outcomes — creatinine, glomerular filtration rate, cystatin-C, and oxidized lipoproteins — showed favorable changes in the febuxostat group. No significant differences were found in urine albumin and lipid profile parameters. Based on these findings, febuxostat is evaluated as a superior therapeutic agent for the stable control of uric acid metabolism and preservation of renal function in patients with chronic kidney failure.
References
1. Richette P., Bardin T. Gout // Lancet. — 2010. — Vol. 375. — P. 318–328.
2. Vitart V., Rudan I., Hayward C., Gray N.K., Floyd J., Palmer C.N., et al. SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout // Nature Genetics. — 2008. — Vol. 40. — P. 437–442.
3. Eggebeen A.T. Gout: an update // American Family Physician. — 2007. — Vol. 76. — P. 801–808.
4. Drapkina O.M., Mazurov V.I., Martynov A.I., Gaidukova I.Z., Duplyakov D.V., Nevzorova V.A. i dr. «В фокусе гиперурикемия». Резолюция Совета экспертов // Кардиоваскулярная терапия и профилактика. 2023;22(4):3564. doi:10.15829/1728 8800 2023 3564
5. Hille R. Molybdenum-containing hydroxylases // Archives of Biochemistry and Biophysics. — 2005. — Vol. 433. — P. 107–116.
6. Harrison R. Structure and function of xanthine oxidoreductase: where are we now? // Free Radical Biology and Medicine. — 2002. — Vol. 33. — P. 774–797.
7. Gray C.L., Walters-Smith N.E. Febuxostat for treatment of chronic gout // American Journal of Health-System Pharmacy. — 2011. — Vol. 68. — P. 389–398.
8. Love B.L., Barrons R., Veverka A., Snider K.M. Urate-lowering therapy for gout: focus on febuxostat // Pharmacotherapy. — 2010. — Vol. 30. — P. 594–608.
9. Рамеев В.В., Елисеев М.С., Моисеев С.В. «Концепция аутовоспаления в генезе подагры и гиперурикемии» // Клиническая фармакология и терапия. 2019;2019(2):28–33. doi:10.32756/0869 5490 2019 2 28 33
10. Chao J., Terkeltaub R. A critical reappraisal of allopurinol dosing, safety, and efficacy for hyperuricemia in gout // Current Rheumatology Reports. — 2009. — Vol. 11, No. 2. — P. 135–140.
11. Dubchak N., Falasca G.F. New and improved strategies for the treatment of gout // International Journal of Nephrology and Renovascular Disease. — 2010. — Vol. 3. — P. 145–166.
12 Eliseev M.S., Zhelyabina O.V., Cheremushkina E.V. «Сравнение частоты и количества употребления в пищу мясных продуктов у пациентов с подагрой и асимптоматической гиперурикемией (предварительные данные пилотного исследования)» // Вестник ревматологии. 2022–2023.
13 . Khanna D., Khanna P.P., Fitzgerald J.D., Singh M.K., Bae S., Neogi T., Pillinger M.H., et al. American College of Rheumatology guidelines for management of gout. Part 2: therapy and anti-inflammatory prophylaxis of acute gouty arthritis // Arthritis Care & Research. — 2012. — Vol. 64, No. 10. — P. 1447–1461.
14. Köttgen A., Albrecht E., Teumer A., Vitart V., Krumsiek J., Hundertmark C., et al. Genome-wide association analyses identify 18 new loci associated with serum urate concentrations // Nature Genetics. — 2013. — Vol. 45, No. 2. — P. 145–154.
15. Молекулярно-генетические предикторы развития подагры: обзор тяжести и клинического течения заболевания // Научный журнал NA-Journal, 2024.
