Efficacy of febuxostat in hyperuricemic patients with mild-to-moderate chronic kidney disease: a meta-analysis of randomized clinical trials. Issue 13 (March 2018)

• Record Type: Journal Article
• Authors: Zeng, Xiang Xia; Tang, Yunliang; Hu, Kaixiang; Zhou, Xi; Wang, Jiao; Zhu, Lingyan; Liu, Jianying; Xu, Jixiong
• Other Names: Calderon. Lindsay section editor.
• Is Part Of: Medicine. Volume 97:Issue 13(2018)
• Publication Date: 2018-03
• Subjects: chronic kidney disease -- efficacy -- febuxostat -- hyperuricemia -- meta-analysis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000010161
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: To investigate the efficacy of febuxostat in hyperuricemic patients with chronic kidney disease (CKD), relevant randomized clinical trials (RCTs) were analyzed. Methods: We used PubMed, Medline, ISI Web of Science, CBMdisc, and Cochrane Library databases to conduct a systematic literature research. A fixed-effects model was used to evaluate the standardized mean differences (SMDs) with 95% confidence intervals (CIs). We conducted subgroup analysis, sensitivity analysis, and analyzed publication bias, to comprehensively estimate the renoprotective effects of febuxostat in hyperuricemic patients with CKD. Results: Among 296 retrieved studies, 5 relevant RCTs were included in the meta-analysis. The result showed that serum estimated glomerular filtration rate (eGFR) was improved after febuxostat treatment in hyperuricemic patients with CKD, with an SMD (95% CI) of 0.24 [−0.17 to 0.43] and P = .67 (fixed-effects model). No heterogeneity was observed across studies ( I 2 = 0% and P = .67). Subgroup analysis suggested that treatment-related reductions in serum eGFR levels were not related to drug doses, intervention times, or region. Conclusions: The present meta-analysis suggests that febuxostat may slow the progression of mild-to-moderate CKD. Given the limited number of included studies, additional large sample-size RCTs are required to determine the long-term renoprotective effects of febuxostat in hyperuricemic patients with CKD.