Efficiency of Febuxostat in Gout Patients with Arterial Hypertension and Reduced Glomerular Filtration Rate: An Exploratory Study
Purpose. To evaluate the efficacy and safety of febuxostat in gout patients with arterial hypertension and reduced glomerular filtration rate. Materials and methods. The current prospective study included 36 patients with gout for an average of 5.5 (IQR 3.25-10.00) years. Depending on the clinical manifestations of gout, patients are divided into patients with tophi (16 people) and without tophi (20 people). Among the included patients were 12 women and 24 men with a mean age of 60.00 (IQR 45.25-65.75) years. Before treatment, the level of systolic blood pressure was 160.00 (IQR: 150.00-170.00) mmHg, diastolic - 92.00 (IQR: 90.00-100.00) mmHg, the level of GFR was 64.14 (IQR 51.57-88.36) ml/min/1.73 m2. For the treatment were used febuxostat at a dose of 80 mg 1 time per day for 1 month. Results. The average level of uric acid before therapy was 535.50 (IQR 496.50-625.75) μmol/l, two weeks later - 495.50 (IQR 442.50-534.00) μmol/l, a month later - 379.00 (IQR 366.50-403.25) μmol/l. The creatinine level decreased from 101.00 (IQR 78.00-121.00) μmol/l to 96 (IQR 76-120) μmol/l after a month. Statically significant (p<0.05) increased GFR from 64.14 (IQR 51.57-88.36) ml/min/1.73 m2 before treatment to 68.61 (IQR 51.72- 91.1) ml/min/1.73 m2 after. Significant decrease arterial hypertension was obtained after 1 month of febuxostat use (systolic blood pressure - 150.00 (IQR: 136.00-160.00) mm Hg (p<0.001), diastolic - 90.00 (IQR: 80.00-94.00) mm Hg (p<0.001)) without changing antihypertensive therapy. There was a tendency to reduce the level of total cholesterol, which was - 6.15 (IQR 5.25-6.7) mmol/l before treatment, 5.7 (IQR 5.2-6.4) mmol/l after a month, but statistically insignificant (p<0.06). Conclusion. The use of febuxostat in patients with arterial hypertension and reduced glomerular filtration rate can effectively reduce blood pressure and improve renal function.