Format

Send to

Choose Destination
Eur Heart J. 2019 Jun 7;40(22):1778-1786. doi: 10.1093/eurheartj/ehz119.

Febuxostat for Cerebral and CaRdiorenovascular Events PrEvEntion StuDy.

Author information

1
Department of General Internal Medicine 3, Kawasaki Medical School General Center, 2-6-1 Nakasange, Kita-ku, Okayama, Japan.
2
Department of Family, Community, and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, Japan.
3
Hiramitsu Heart Clinic, 2-35 Shiroshita-cho, Minami-ku, Nagoya, Japan.
4
Institute of Regenerative Medicine and Biofunction, Tottori University Graduate School of Medical Science, 86 Nishi-machi, Yonago, Japan.
5
Shizuoka City Shizuoka Hospital, 10-93 Ote-machi, Aoi-ku, Shizuoka, Japan.
6
Uchiyama Clinic, 1161-1 Shita-machi, Yoshikawa-ku, Joetsu, Japan.
7
Yokota Naika, 642-1 Komuta, Hanagashima-cho, Miyazaki, Japan.
8
Tokutake Iin, 2-28-1 Asahi, Kawaguchi, Japan.
9
Wakasa Medical Clinic, 3-16-25 Sainen, Kanazawa, Japan.
10
Jinnouchi Hospital Diabetes Care Center, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, Japan.
11
Kakuda Iin, Na 15-1, Takamatsu, Kahoku, Japan.
12
Hayashi Medical Clinic, 5-22 Nakamozu-cho, Kita-ku, Sakai, Japan.
13
Kawai Naika Clinic, 4-9 Tono-machi, Gifu, Japan.
14
Yokohama Sotetsu Bldg Clinic of Internal Medicine, 1-11-5 Kitasaiwai, Nishi-ku, Yokohama, Japan.
15
Sugawara Clinic, 3-9-16 Shakujii-machi, Nerima-ku, Japan.
16
Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa, Japan.
17
Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Japan.
18
Department of Cardiovascular Medicine, Nara Medical University, 840 Shijyo-cho, Kashihara, Japan.
19
National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Japan.

Abstract

AIMS:

To compare the occurrence of cerebral, cardiovascular, and renal events in patients with hyperuricaemia treated with febuxostat and those treated with conventional therapy with lifestyle modification.

METHODS AND RESULTS:

This multicentre, prospective, randomized open-label, blinded endpoint study was done in 141 hospitals in Japan. A total of 1070 patients were included in the intention-to-treat population. Elderly patients with hyperuricaemia (serum uric acid >7.0 to ≤9.0 mg/dL) at risk for cerebral, cardiovascular, or renal disease, defined by the presence of hypertension, Type 2 diabetes, renal disease, or history of cerebral or cardiovascular disease, were randomized to febuxostat and non-febuxostat groups and were observed for 36 months. Cerebral, cardiovascular, and renal events and all deaths were defined as the primary composite event. The serum uric acid level at endpoint (withdrawal or completion of the study) in the febuxostat (n = 537) and non-febuxostat groups (n = 533) was 4.50 ± 1.52 and 6.76 ± 1.45 mg/dL, respectively (P < 0.001). The primary composite event rate was significantly lower in the febuxostat group than in non-febuxostat treatment [hazard ratio (HR) 0.750, 95% confidence interval (CI) 0.592-0.950; P = 0.017] and the most frequent event was renal impairment (febuxostat group: 16.2%, non-febuxostat group: 20.5%; HR 0.745, 95% CI 0.562-0.987; P = 0.041).

CONCLUSION:

Febuxostat lowers uric acid and delays the progression of renal dysfunction.

REGISTRATION:

ClinicalTrials.gov (NCT01984749).

KEYWORDS:

Cardiovascular disease ; Cerebral disease ; Elderly patient ; Febuxostat ; Hyperuricaemia ; Renal disease

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center