Febuxostat is safe and effective for treating gout in patients on dialysis, according to a new study.
The study was a retrospective review of clinical and laboratory data from 62 dialysis patients (45 on hemodialysis and 17 on peritoneal dialysis) with gout treated with febuxostat. The mean serum uric acid level decreased significantly from 9.36 mg/dL prior to treatment to 3.71 mg/dL after 3 months of treatment, See Yoon Choi, MD, of Ulsan University Hospital in Ulsan, Korea, and colleagues reported in the Internal Medicine Journal. The serum uric acid level was significantly reduced at 3 months in both HD and PD patients, and subsequently remained at a significantly reduced level for 12 months. Of the 62 patients, only 2 discontinued febuxostat because of its adverse effects.
An initial dose of 80 mg per day was associated with 8.2-fold increased odds of adverse events compared with a dose of 20 to 40 mg per day, according to the investigators.
“Febuxostat taken at a dose of 20-40 mg per day might be [the] appropriate initial dose in patients undergoing dialysis,” the authors concluded.
Choi SY, Choi SW, Lee S, et al. The efficacy and tolerability of febuxostat in gout patients on dialysis [published online February 11, 2020]. Intern Med J. doi: 10.1111/imj.14776