Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis
Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large‐scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD ar...
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| Veröffentlicht in: | Clinical pharmacology and therapeutics 2020-05, Vol.107 (5), p.1159-1169 |
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| creator | Hsu, Yun‐Shiuan O. Wu, I‐Wen Chang, Shang‐Hung Lee, Cheng‐Chia Tsai, Chung‐Ying Lin, Chan‐Yu Lin, Wan‐Ting Huang, Yu‐Tung Wu, Chao‐Yi Kuo, George Hsiao, Chih‐Yen Lin, Hsing‐Lin Yang, Chih‐Chao Yen, Tzung‐Hai Chen, Yung‐Chang Hung, Cheng‐Chieh Tian, Ya‐Chong Kuo, Chang‐Fu Yang, Chih‐Wei Anderson, Gerard F. Yang, Huang‐Yu |
| description | Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large‐scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD are lacking. We exclusively selected 6,057 eligible patients with predialysis stage 5 CKD prescribed either febuxostat or allopurinol using the National Health Insurance Research Database in Taiwan during 2012–2015. There were 69.57% of allopurinol users and 42.01% febuxostat users who required long‐term dialysis (P |
| doi_str_mv | 10.1002/cpt.1697 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7232862</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>CPT1697</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4107-49b279bb7d9b1a411cf7262ed7281f88441edb6d05a321ba98ceba2b03a9ee63</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxi1ERbcFiSdAPnJJsZ3EcTggrdI_ICpYwd6tcTxpjbJ2ZGdb9kV4XrxdqOiB08xovvl9I32EvObsjDMm3vXTfMZl2zwjC16XopB1WT8nC8ZYW7SilMfkJKUfeaxapV6Q45JLoZSsFuRXFzYTRJjdHdJv6MMUw4z9w3gxDLmjYaCXaLY_Q5phpuAtXY5jmLbR-TBS5-kqonUw7pJL9PsMN0hr2t3G4F1PPzvrcUfPXUJISFfZCP2c3tMl_ZL74O-dRXoOM5j9fukPnJfkaIAx4as_9ZSsLy_W3cfi-uvVp255XfQVZ01RtUY0rTGNbQ2HivN-aIQUaBuh-KBUVXG0RlpWQym4gVb1aEAYVkKLKMtT8uGAnbZmg7bPr0UY9RTdBuJOB3D66ca7W30T7nQjSqGkyIC3B0AfQ0oRh8dbzvQ-Gp2j0ftosvTNv16Pwr9ZZEFxENy7EXf_BelutX4A_gZ5-pyQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Hsu, Yun‐Shiuan O. ; Wu, I‐Wen ; Chang, Shang‐Hung ; Lee, Cheng‐Chia ; Tsai, Chung‐Ying ; Lin, Chan‐Yu ; Lin, Wan‐Ting ; Huang, Yu‐Tung ; Wu, Chao‐Yi ; Kuo, George ; Hsiao, Chih‐Yen ; Lin, Hsing‐Lin ; Yang, Chih‐Chao ; Yen, Tzung‐Hai ; Chen, Yung‐Chang ; Hung, Cheng‐Chieh ; Tian, Ya‐Chong ; Kuo, Chang‐Fu ; Yang, Chih‐Wei ; Anderson, Gerard F. ; Yang, Huang‐Yu</creator><creatorcontrib>Hsu, Yun‐Shiuan O. ; Wu, I‐Wen ; Chang, Shang‐Hung ; Lee, Cheng‐Chia ; Tsai, Chung‐Ying ; Lin, Chan‐Yu ; Lin, Wan‐Ting ; Huang, Yu‐Tung ; Wu, Chao‐Yi ; Kuo, George ; Hsiao, Chih‐Yen ; Lin, Hsing‐Lin ; Yang, Chih‐Chao ; Yen, Tzung‐Hai ; Chen, Yung‐Chang ; Hung, Cheng‐Chieh ; Tian, Ya‐Chong ; Kuo, Chang‐Fu ; Yang, Chih‐Wei ; Anderson, Gerard F. ; Yang, Huang‐Yu</creatorcontrib><description>Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large‐scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD are lacking. We exclusively selected 6,057 eligible patients with predialysis stage 5 CKD prescribed either febuxostat or allopurinol using the National Health Insurance Research Database in Taiwan during 2012–2015. There were 69.57% of allopurinol users and 42.01% febuxostat users who required long‐term dialysis (P < 0.0001). The adjusted hazard ratio (HR) of 0.65 (95% confidence interval (CI) 0.60–0.70) indicated near 35% lower hazards of long‐term dialysis with febuxostat use. The renal benefit of febuxostat was consistent across most patient subgroups and/or using the propensity score‐matched cohort. The adjusted HR was 0.66 (95% CI, 0.61–0.70) for long‐term dialysis or death. In conclusion, lower risk of progression to dialysis was observed in predialysis stage 5 CKD febuxostat users without compromising survival.</description><identifier>ISSN: 0009-9236</identifier><identifier>EISSN: 1532-6535</identifier><identifier>DOI: 10.1002/cpt.1697</identifier><identifier>PMID: 31628864</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Allopurinol - administration & dosage ; Allopurinol - pharmacology ; Cohort Studies ; Databases, Factual ; Disease Progression ; Febuxostat - administration & dosage ; Febuxostat - pharmacology ; Female ; Gout Suppressants - administration & dosage ; Gout Suppressants - pharmacology ; Humans ; Hyperuricemia - drug therapy ; Hyperuricemia - physiopathology ; Male ; Middle Aged ; Renal Insufficiency, Chronic - drug therapy ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Taiwan ; Young Adult</subject><ispartof>Clinical pharmacology and therapeutics, 2020-05, Vol.107 (5), p.1159-1169</ispartof><rights>2019 The Authors. published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.</rights><rights>2019 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4107-49b279bb7d9b1a411cf7262ed7281f88441edb6d05a321ba98ceba2b03a9ee63</citedby><cites>FETCH-LOGICAL-c4107-49b279bb7d9b1a411cf7262ed7281f88441edb6d05a321ba98ceba2b03a9ee63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcpt.1697$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcpt.1697$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31628864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsu, Yun‐Shiuan O.</creatorcontrib><creatorcontrib>Wu, I‐Wen</creatorcontrib><creatorcontrib>Chang, Shang‐Hung</creatorcontrib><creatorcontrib>Lee, Cheng‐Chia</creatorcontrib><creatorcontrib>Tsai, Chung‐Ying</creatorcontrib><creatorcontrib>Lin, Chan‐Yu</creatorcontrib><creatorcontrib>Lin, Wan‐Ting</creatorcontrib><creatorcontrib>Huang, Yu‐Tung</creatorcontrib><creatorcontrib>Wu, Chao‐Yi</creatorcontrib><creatorcontrib>Kuo, George</creatorcontrib><creatorcontrib>Hsiao, Chih‐Yen</creatorcontrib><creatorcontrib>Lin, Hsing‐Lin</creatorcontrib><creatorcontrib>Yang, Chih‐Chao</creatorcontrib><creatorcontrib>Yen, Tzung‐Hai</creatorcontrib><creatorcontrib>Chen, Yung‐Chang</creatorcontrib><creatorcontrib>Hung, Cheng‐Chieh</creatorcontrib><creatorcontrib>Tian, Ya‐Chong</creatorcontrib><creatorcontrib>Kuo, Chang‐Fu</creatorcontrib><creatorcontrib>Yang, Chih‐Wei</creatorcontrib><creatorcontrib>Anderson, Gerard F.</creatorcontrib><creatorcontrib>Yang, Huang‐Yu</creatorcontrib><title>Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis</title><title>Clinical pharmacology and therapeutics</title><addtitle>Clin Pharmacol Ther</addtitle><description>Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large‐scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD are lacking. We exclusively selected 6,057 eligible patients with predialysis stage 5 CKD prescribed either febuxostat or allopurinol using the National Health Insurance Research Database in Taiwan during 2012–2015. There were 69.57% of allopurinol users and 42.01% febuxostat users who required long‐term dialysis (P < 0.0001). The adjusted hazard ratio (HR) of 0.65 (95% confidence interval (CI) 0.60–0.70) indicated near 35% lower hazards of long‐term dialysis with febuxostat use. The renal benefit of febuxostat was consistent across most patient subgroups and/or using the propensity score‐matched cohort. The adjusted HR was 0.66 (95% CI, 0.61–0.70) for long‐term dialysis or death. In conclusion, lower risk of progression to dialysis was observed in predialysis stage 5 CKD febuxostat users without compromising survival.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Allopurinol - administration & dosage</subject><subject>Allopurinol - pharmacology</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Disease Progression</subject><subject>Febuxostat - administration & dosage</subject><subject>Febuxostat - pharmacology</subject><subject>Female</subject><subject>Gout Suppressants - administration & dosage</subject><subject>Gout Suppressants - pharmacology</subject><subject>Humans</subject><subject>Hyperuricemia - drug therapy</subject><subject>Hyperuricemia - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Renal Insufficiency, Chronic - drug therapy</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Taiwan</subject><subject>Young Adult</subject><issn>0009-9236</issn><issn>1532-6535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc9u1DAQxi1ERbcFiSdAPnJJsZ3EcTggrdI_ICpYwd6tcTxpjbJ2ZGdb9kV4XrxdqOiB08xovvl9I32EvObsjDMm3vXTfMZl2zwjC16XopB1WT8nC8ZYW7SilMfkJKUfeaxapV6Q45JLoZSsFuRXFzYTRJjdHdJv6MMUw4z9w3gxDLmjYaCXaLY_Q5phpuAtXY5jmLbR-TBS5-kqonUw7pJL9PsMN0hr2t3G4F1PPzvrcUfPXUJISFfZCP2c3tMl_ZL74O-dRXoOM5j9fukPnJfkaIAx4as_9ZSsLy_W3cfi-uvVp255XfQVZ01RtUY0rTGNbQ2HivN-aIQUaBuh-KBUVXG0RlpWQym4gVb1aEAYVkKLKMtT8uGAnbZmg7bPr0UY9RTdBuJOB3D66ca7W30T7nQjSqGkyIC3B0AfQ0oRh8dbzvQ-Gp2j0ftosvTNv16Pwr9ZZEFxENy7EXf_BelutX4A_gZ5-pyQ</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Hsu, Yun‐Shiuan O.</creator><creator>Wu, I‐Wen</creator><creator>Chang, Shang‐Hung</creator><creator>Lee, Cheng‐Chia</creator><creator>Tsai, Chung‐Ying</creator><creator>Lin, Chan‐Yu</creator><creator>Lin, Wan‐Ting</creator><creator>Huang, Yu‐Tung</creator><creator>Wu, Chao‐Yi</creator><creator>Kuo, George</creator><creator>Hsiao, Chih‐Yen</creator><creator>Lin, Hsing‐Lin</creator><creator>Yang, Chih‐Chao</creator><creator>Yen, Tzung‐Hai</creator><creator>Chen, Yung‐Chang</creator><creator>Hung, Cheng‐Chieh</creator><creator>Tian, Ya‐Chong</creator><creator>Kuo, Chang‐Fu</creator><creator>Yang, Chih‐Wei</creator><creator>Anderson, Gerard F.</creator><creator>Yang, Huang‐Yu</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>202005</creationdate><title>Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis</title><author>Hsu, Yun‐Shiuan O. ; Wu, I‐Wen ; Chang, Shang‐Hung ; Lee, Cheng‐Chia ; Tsai, Chung‐Ying ; Lin, Chan‐Yu ; Lin, Wan‐Ting ; Huang, Yu‐Tung ; Wu, Chao‐Yi ; Kuo, George ; Hsiao, Chih‐Yen ; Lin, Hsing‐Lin ; Yang, Chih‐Chao ; Yen, Tzung‐Hai ; Chen, Yung‐Chang ; Hung, Cheng‐Chieh ; Tian, Ya‐Chong ; Kuo, Chang‐Fu ; Yang, Chih‐Wei ; Anderson, Gerard F. ; Yang, Huang‐Yu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4107-49b279bb7d9b1a411cf7262ed7281f88441edb6d05a321ba98ceba2b03a9ee63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Allopurinol - administration & dosage</topic><topic>Allopurinol - pharmacology</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Disease Progression</topic><topic>Febuxostat - administration & dosage</topic><topic>Febuxostat - pharmacology</topic><topic>Female</topic><topic>Gout Suppressants - administration & dosage</topic><topic>Gout Suppressants - pharmacology</topic><topic>Humans</topic><topic>Hyperuricemia - drug therapy</topic><topic>Hyperuricemia - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Renal Insufficiency, Chronic - drug therapy</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Retrospective Studies</topic><topic>Taiwan</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hsu, Yun‐Shiuan O.</creatorcontrib><creatorcontrib>Wu, I‐Wen</creatorcontrib><creatorcontrib>Chang, Shang‐Hung</creatorcontrib><creatorcontrib>Lee, Cheng‐Chia</creatorcontrib><creatorcontrib>Tsai, Chung‐Ying</creatorcontrib><creatorcontrib>Lin, Chan‐Yu</creatorcontrib><creatorcontrib>Lin, Wan‐Ting</creatorcontrib><creatorcontrib>Huang, Yu‐Tung</creatorcontrib><creatorcontrib>Wu, Chao‐Yi</creatorcontrib><creatorcontrib>Kuo, George</creatorcontrib><creatorcontrib>Hsiao, Chih‐Yen</creatorcontrib><creatorcontrib>Lin, Hsing‐Lin</creatorcontrib><creatorcontrib>Yang, Chih‐Chao</creatorcontrib><creatorcontrib>Yen, Tzung‐Hai</creatorcontrib><creatorcontrib>Chen, Yung‐Chang</creatorcontrib><creatorcontrib>Hung, Cheng‐Chieh</creatorcontrib><creatorcontrib>Tian, Ya‐Chong</creatorcontrib><creatorcontrib>Kuo, Chang‐Fu</creatorcontrib><creatorcontrib>Yang, Chih‐Wei</creatorcontrib><creatorcontrib>Anderson, Gerard F.</creatorcontrib><creatorcontrib>Yang, Huang‐Yu</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical pharmacology and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsu, Yun‐Shiuan O.</au><au>Wu, I‐Wen</au><au>Chang, Shang‐Hung</au><au>Lee, Cheng‐Chia</au><au>Tsai, Chung‐Ying</au><au>Lin, Chan‐Yu</au><au>Lin, Wan‐Ting</au><au>Huang, Yu‐Tung</au><au>Wu, Chao‐Yi</au><au>Kuo, George</au><au>Hsiao, Chih‐Yen</au><au>Lin, Hsing‐Lin</au><au>Yang, Chih‐Chao</au><au>Yen, Tzung‐Hai</au><au>Chen, Yung‐Chang</au><au>Hung, Cheng‐Chieh</au><au>Tian, Ya‐Chong</au><au>Kuo, Chang‐Fu</au><au>Yang, Chih‐Wei</au><au>Anderson, Gerard F.</au><au>Yang, Huang‐Yu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis</atitle><jtitle>Clinical pharmacology and therapeutics</jtitle><addtitle>Clin Pharmacol Ther</addtitle><date>2020-05</date><risdate>2020</risdate><volume>107</volume><issue>5</issue><spage>1159</spage><epage>1169</epage><pages>1159-1169</pages><issn>0009-9236</issn><eissn>1532-6535</eissn><abstract>Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large‐scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD are lacking. We exclusively selected 6,057 eligible patients with predialysis stage 5 CKD prescribed either febuxostat or allopurinol using the National Health Insurance Research Database in Taiwan during 2012–2015. There were 69.57% of allopurinol users and 42.01% febuxostat users who required long‐term dialysis (P < 0.0001). The adjusted hazard ratio (HR) of 0.65 (95% confidence interval (CI) 0.60–0.70) indicated near 35% lower hazards of long‐term dialysis with febuxostat use. The renal benefit of febuxostat was consistent across most patient subgroups and/or using the propensity score‐matched cohort. The adjusted HR was 0.66 (95% CI, 0.61–0.70) for long‐term dialysis or death. In conclusion, lower risk of progression to dialysis was observed in predialysis stage 5 CKD febuxostat users without compromising survival.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>31628864</pmid><doi>10.1002/cpt.1697</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Allopurinol - administration & dosage Allopurinol - pharmacology Cohort Studies Databases, Factual Disease Progression Febuxostat - administration & dosage Febuxostat - pharmacology Female Gout Suppressants - administration & dosage Gout Suppressants - pharmacology Humans Hyperuricemia - drug therapy Hyperuricemia - physiopathology Male Middle Aged Renal Insufficiency, Chronic - drug therapy Renal Insufficiency, Chronic - physiopathology Retrospective Studies Taiwan Young Adult |
| title | Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis |
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