Abstract: TH-PO497
Reduction in Uric Acid Correlates with Better eGFR in Patients with Hyperuricemia and CKD Treated with XOIs – A Systematic Meta-Analysis
Session Information
- CKD: Clinical Trials and Tubulointerstitial Disorders
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 305 CKD: Clinical Trials and Tubulointerstitial Disorders
Authors
- Erlandsson, Fredrik, AstraZeneca R&D, Gothenburg, Sweden
- Johnsson, Eva K.A., AstraZeneca R&D, Gothenburg, Sweden
- Hellsten kronander, Anna, AstraZeneca R&D, Gothenburg, Sweden
- Bjursell, Magnus K, AstraZeneca R&D, Gothenburg, Sweden
- Andersson, Magnus, AstraZeneca R&D, Gothenburg, Sweden
Background
Hyperuricemia may contribute to worsening of renal function in patients with chronic kidney disease (CKD). Uric acid (UA) lowering xanthine oxidase inhibitors (XOIs) may therefore preserve GFR.
Methods
TrialTrove was queried for studies with results using the terms “+Uricosuric agent or xanthine oxidase inhibitor”. Of 660 trials 8 were published randomized clinical trials in patients with hyperuricemia and CKD treated with XOI. The effect of XOI treatment relative to control on eGFR and the impact of reduction in serum uric acid on eGFR was assessed in a random effects meta-analysis model.
Results
Estimated GFR at end of treatment was significantly higher in the XOI arms (p<0.035) without significant heterogeneity in effect (p-value=0.075, I2- index: 45.7%). Greater reduction in UA correlated with better eGFR at the end of treatment (p<0.0062).
Conclusion
Renal function may benefit from intensive UA lowering therapy in CKD. Prospective studies of intensive UA lowering in CKD are warranted.
Included studies
| Follow up | Experimental Arm | Control Arm | |||
| Reference | Months | Intervention | N | Intervention | N |
| Sircar 2015 | 6 | febuxostat | 45 | placebo | 48 |
| Tani 2015 | 6 | febuxostat | 30 | placebo | 30 |
| Sezai 2015 | 6 | febuxostat | 56 | allopurinol | 53 |
| Kanbay 2010 | 4 | allopurinol | 30 | placebo | 37 |
| Goicoechea 2010 | 24 | allopurinol | 56 | placebo | 57 |
| Tanaka 2015 | 3 | febuxostat | 21 | placebo | 19 |
| Shih 2012 | 6 | allopurinol | 21 | placebo | 19 |
| Hosoya 2014 | 5.5 | topiroxostat | 60 | placebo | 60 |
| Total | 319 | Total | 323 | ||
Funding
- Commercial Support –