Efficacy of febuxostat in hyperuricemic patients with mild-to-moderate chronic kidney disease: a meta-analysis of randomized clinical trials: A PRISMA-compliant article.

Existing Reviews

Please note, new claims can take a short while to show up.

No claims yet.

Annotation Summary

Term Occurence Count Dictionary
febuxostat 56 endocrinologydiseasesdrugs
hyperuricemia 4 endocrinologydiseases
obesity 1 endocrinologydiseases
allopurinol 2 endocrinologydiseasesdrugs

Graph of close proximity drug and disease terms (within 200 characters).

Note: If this graph is empty, then there are no terms that meet the proximity constraint.

Review

Having read the paper, please pick a pair of statements from the paper to indicate that a drug and disease are related.

Select Drug Character Offset Drug Term Instance
allopurinol 9613 controlled trials[[22]–[26]] were included in the meta-analysis: 3 RCT studies comparing febuxostat with allopurinol in hyperuricemic patients with CKD[[23],[25],[26]] and 2 comparing febuxostat with placebo in hyperuricemic
allopurinol 10473 old. The duration of therapy ranged from 3 to 48 months. Three RCT studies compared febuxostat with allopurinol in hyperuricemic patients with CKD,[[23],[25],[26]] and 2 compared febuxostat with placebo in hyperuricemic
febuxostat 27 Title: MedicineEfficacy of febuxostat in hyperuricemic patients with mild-to-moderate chronic kidney disease: a meta-analysis of randomized
febuxostat 606 (collection): 3/2018Publication date (epub): 3/2018AbstractAbstractBackground:To investigate the efficacy of febuxostat in hyperuricemic patients with chronic kidney disease (CKD), relevant randomized clinical trials (RCTs)
febuxostat 1137 analysis, and analyzed publication bias, to comprehensively estimate the renoprotective effects of febuxostat in hyperuricemic patients with CKD.Results:Among 296 retrieved studies, 5 relevant RCTs were included
febuxostat 1364 meta-analysis. The result showed that serum estimated glomerular filtration rate (eGFR) was improved after febuxostat treatment in hyperuricemic patients with CKD, with an SMD (95% CI) of 0.24 [−0.17 to 0.43] and P = .67
febuxostat 1780 related to drug doses, intervention times, or region.Conclusions:The present meta-analysis suggests that febuxostat may slow the progression of mild-to-moderate CKD. Given the limited number of included studies, additional
febuxostat 1987 additional large sample-size RCTs are required to determine the long-term renoprotective effects of febuxostat in hyperuricemic patients with CKD.Introduction1Hyperuricemia is a common complication of chronic kidney
febuxostat 3020 associated with activation of XO, endothelial dysfunction, and/or tubular injury.[[10]–[12]] Moreover, febuxostat ameliorates the progression of CKD by decreasing oxidative stress, and suppressing endothelial dysfunction
febuxostat 3254 injury.[[13]] It is primarily eliminated by the liver, and is well tolerated by CKD patients. Moreover, febuxostat may not only by reducing circulating uric acid levels, but also through the other mechanisms, including
febuxostat 3574 afferent arteriolar thickening, and ischemic renal histologic changes, to ameliorate renal damage. In all, febuxostat may be effective for preventing the progression of renal function progress in patients with CKD.However,
febuxostat 3719 the progression of renal function progress in patients with CKD.However, the renoprotective effect of febuxostat remains controversial. Although some studies reported positive results,[[14]–[16]] others found it
febuxostat 4022 CKD.[[17]–[19]] Furthermore, no systematic studies demonstrating whether renal function is improved after febuxostat therapy in hyperuricemic patients with CKD have been reported.To determine the renoprotective effects
febuxostat 4138 therapy in hyperuricemic patients with CKD have been reported.To determine the renoprotective effects of febuxostat in hyperuricemic patients with CKD, we performed a systematic literature review and meta-analysis of
febuxostat 4681 discussed below for studies published up until September 2017 that assessed the renoprotective effects of febuxostat in hyperuricemic patients with CKD.We searched the following electronic databases for RCTs published
febuxostat 5477 measured SUA and estimated glomerular filtration rate (eGFR) in hyperuricemic patients with CKD undergoing febuxostat therapy as part of randomized controlled trials; studies that reported baseline and follow-up data on
febuxostat 6394 independently by 2 investigators (Zeng and Tang). Clinical trials that assessed the renoprotective effects of febuxostat in hyperuricemic patients with CKD were selected for review. The 2 investigators blindly collected all
febuxostat 6577 investigators blindly collected all recorded information pertaining to general characteristics, doses of febuxostat , duration of treatment, and outcomes (mean and SD values of SUA and eGFR before and after administration
febuxostat 6696 duration of treatment, and outcomes (mean and SD values of SUA and eGFR before and after administration of febuxostat ). If raw data were not provided, they were extracted from figures and tables as necessary. Any disagreement
febuxostat 7491 difference (SMD) and 95% confidence intervals (CIs) of eGFR to estimate the renoprotective effect of febuxostat . We estimated statistical heterogeneity among the included studies using the I2 statistic 0.22 and the
febuxostat 9447 the inclusion criteria, and 2 measured serum creatinine in hyperuricemic patients with CKD undergoing febuxostat therapy. Therefore, 5 randomized, double-blind, controlled trials[[22]–[26]] were included in the
febuxostat 9597 double-blind, controlled trials[[22]–[26]] were included in the meta-analysis: 3 RCT studies comparing febuxostat with allopurinol in hyperuricemic patients with CKD[[23],[25],[26]] and 2 comparing febuxostat with
febuxostat 9692 comparing febuxostat with allopurinol in hyperuricemic patients with CKD[[23],[25],[26]] and 2 comparing febuxostat with placebo in hyperuricemic patients with CKD.[[22],[24]]Figure 1Flow diagram of literature search
febuxostat 10067 meta-analysis, a total of 835 subjects were enrolled. Among them, 437 subjects were randomized to receive febuxostat . Three studies were conducted in Eastern countries[[22],[23],[26]] and 2 were conducted in Western countries.[[24],[25]]
febuxostat 10229 countries[[22],[23],[26]] and 2 were conducted in Western countries.[[24],[25]] One of the studies (comparing febuxostat vs placebo) did not provide the mean age and SD for each group of patients,[[24]] whereas the others
febuxostat 10457 patients >18 years old. The duration of therapy ranged from 3 to 48 months. Three RCT studies compared febuxostat with allopurinol in hyperuricemic patients with CKD,[[23],[25],[26]] and 2 compared febuxostat with
febuxostat 10552 compared febuxostat with allopurinol in hyperuricemic patients with CKD,[[23],[25],[26]] and 2 compared febuxostat with placebo in hyperuricemic patients with CKD.[[22],[24]] The doses of febuxostat ranged from 40 to
febuxostat 10636 and 2 compared febuxostat with placebo in hyperuricemic patients with CKD.[[22],[24]] The doses of febuxostat ranged from 40 to 240 mg/d. Table 3 shows the risk of bias of randomized trials included in the meta-analysis.
febuxostat 11730 were significantly improved in hyperuricemic patients with CKD compared with the same patient before febuxostat treatment controls (fixed-effects model, SMD = 0.24, 95% CI = [−0.17 to 0.43]; Fig. 2.) and
febuxostat 12378 according to region (Eastern or Western), duration of therapy (≤6 months or >6 months), and dose of febuxostat (<40 mg/d or ≥40 mg/d). In the subgroup analysis, the overall pattern of pooled effect did not
febuxostat 12616 potential sources of heterogeneity, including region and duration of therapy (Table 4). The dose of febuxostat ranged from 40 to 240 mg/d. We performed subgroup analysis for the low-dose (≤40 mg/d) and high-dose
febuxostat 12749 240 mg/d. We performed subgroup analysis for the low-dose (≤40 mg/d) and high-dose (≥40 mg/d) febuxostat groups (Fig. 3). According to the results, the low-dose (≤40 mg/d) febuxostat group did not show
febuxostat 12831 high-dose (≥40 mg/d) febuxostat groups (Fig. 3). According to the results, the low-dose (≤40 mg/d) febuxostat group did not show heterogeneity (fixed-effects model, SMD = 0.25, 95% CI = [−0.19 to 0.69],
febuxostat 13011 SMD = 0.25, 95% CI = [−0.19 to 0.69], I2 = 0% and P = .46) well as the high-dose (≥40 mg/d) febuxostat group (fixed-effects model, SMD = 0.24, 95% CI = [0.03–0.45], I2 = 0% and P = .40).
febuxostat 13212 P = .40). Furthermore, we conducted subgroup analysis for groups that received different doses of febuxostat (Fig. 4). The outcome of the analysis showed that those who received 240 mg/d febuxostat had increased
febuxostat 13303 doses of febuxostat (Fig. 4). The outcome of the analysis showed that those who received 240 mg/d febuxostat had increased renoprotective effects (fixed-effects model, test for overall effect: P = .01). The
febuxostat 13756 studies.Figure 3Meta-analysis of subgroups including low-dose (≤40 mg/d) and high-dose (≥40 mg/d) febuxostat groups before and after treatment, using a fixed-effect model. CI = confidence interval, SMD = standard
febuxostat 13966 SMD = standard mean differences.Figure 4Meta-analysis of data on the comparison of different doses of febuxostat before and after treatment in hyperuricemic patients with CKD, using a fixed-effect model. CI = confidence
febuxostat 15062 showed no publication bias.Figure 5Funnel plot of studies evaluating the association between eGFR and febuxostat in hyperuricemic patients with CKD.Discussion4The present meta-analysis demonstrated that there was
febuxostat 15213 CKD.Discussion4The present meta-analysis demonstrated that there was a significant improvement in eGFR after febuxostat therapy (SMD, −0.46; 95% CI, −0.97 to 0.05; P = .01) in hyperuricemic patients with CKD. The
febuxostat 15503 significant heterogeneity was observed across the included studies. According to subgroup analysis, the febuxostat -treated group (240 mg/d) was the group with the greatest amelioration of renal function (test for
febuxostat 15750 efficacy of 240 mg/d was superior to other doses, and with dose increases, the effect of 240 mg/d febuxostat was significantly enhanced.Hyperuricemia is an independent risk factor for CKD. Large increases or sustained
febuxostat 16119 was associated with significant improvement in the progression of CKD. Therefore, administration of febuxostat may be effective for preventing the progression of renal function progress in patients with CKD.According
febuxostat 16273 progression of renal function progress in patients with CKD.According to the results of our meta-analysis, febuxostat may be effective in ameliorating renal function progress in CKD. Recent studies indicated that the renoprotective
febuxostat 16408 ameliorating renal function progress in CKD. Recent studies indicated that the renoprotective effect of febuxostat may be related to reduction of SUA.[[27]] Febuxostat may decrease tubulointerstitial impairment and
febuxostat 16865 that subgroup analysis according to country, duration, and dose did not change significantly after febuxostat treatment in patients with CKD. Moreover, no significant heterogeneity was observed. However, additional
febuxostat 17048 was observed. However, additional studies are necessary to fully understand the precise mechanism of febuxostat in CKD.The strength of the present meta-analysis is that it is the first comprehensive review to summarize
febuxostat 17233 comprehensive review to summarize the available evidence for assessing the renoprotective effects of febuxostat in hyperuricemic patients with CKD. In addition, the results are stronger than any single study given
febuxostat 17473 demonstrate homogeneity. We are plausible biological mechanisms to explain the renoprotective effect of febuxostat . Our process for data collection was as complete as possible. Furthermore, subgroup analyses of several
febuxostat 17798 these factors, this review should provide convincing evidence regarding the renoprotective effect of febuxostat in hyperuricemic patients with CKD.The present meta-analysis also has limitations. The primary limitation
febuxostat 18879 large sample-size clinical trials should be carried out to further verify the renoprotective effects of febuxostat in hyperuricemic patients with mild-to-moderate CKD.Conclusions5In conclusion, this review represents
febuxostat 19068 this review represents a comprehensive analysis of the assessment of the renoprotective effects of febuxostat and includes only RCTs. It showed that there was significant improvement of serum eGFR after febuxostat
febuxostat 19172 febuxostat and includes only RCTs. It showed that there was significant improvement of serum eGFR after febuxostat treatment in hyperuricemic patients with CKD. Furthermore, the efficacy of 240 mg/d febuxostat was
febuxostat 19269 after febuxostat treatment in hyperuricemic patients with CKD. Furthermore, the efficacy of 240 mg/d febuxostat was superior to other doses, and with dose increases, the effect of 240 mg/d febuxostat was significantly
febuxostat 19359 240 mg/d febuxostat was superior to other doses, and with dose increases, the effect of 240 mg/d febuxostat was significantly increased. The data suggest that febuxostat may ameliorate renal function in early
febuxostat 19421 dose increases, the effect of 240 mg/d febuxostat was significantly increased. The data suggest that febuxostat may ameliorate renal function in early CKD. Additional studies are required to further verify the renoprotective
febuxostat 19556 function in early CKD. Additional studies are required to further verify the renoprotective effects of febuxostat in hyperuricemic patients with CKD. Considering the limited number of studies analyzed, large sample-size
febuxostat 19738 studies analyzed, large sample-size clinical trials are necessary to verify the long-term effects of febuxostat on renal function in CKD.Author contributionsInvestigation: J. Wang, K.X. Hu.Supervision: J.Y. Liu,
Select Disease Character Offset Disease Term Instance
hyperuricemia 2401 regulated by the kidneys. Because urinary uric acid excretion in CKD patients is reduced, the prevalence of hyperuricemia is higher in this patient population.[[7]] Previous studies showed that there is an increased risk of
hyperuricemia 2517 higher in this patient population.[[7]] Previous studies showed that there is an increased risk of hyperuricemia of 11% per 1 mg/dL increase in uric acid.[[8]] Furthermore, individuals with hyperuricemia (>9 mg/dL)
hyperuricemia 2610 risk of hyperuricemia of 11% per 1 mg/dL increase in uric acid.[[8]] Furthermore, individuals with hyperuricemia (>9 mg/dL) have a 3-fold higher risk of developing CKD.[[4]]Febuxostat is a new and potent xanthine
hyperuricemia 2828 oxidase (XO) inhibitor. In 2011, it became the first-line urate-lowering therapy for the treatment of hyperuricemia .[[9]] Hyperuricemia is involved in the pathogenesis of CKD, and might be associated with activation
obesity 18335 comprehensively evaluate the renoprotective effects. Moreover, other measurements such as smoking status, obesity , and other lifestyle factors should be considered confounding factors because the results of our study

You must be authorized to submit a review.