Efficacy of febuxostat in hyperuricemic patients with mild-to-moderate chronic kidney disease: a meta-analysis of randomized clinical trials: A PRISMA-compliant article

• Published in: Medicine (Baltimore) 2018-03, Vol.97 (13), p.e0161-e0161
• Main Authors: Zeng, Xiang Xia, Tang, Yunliang, Hu, Kaixiang, Zhou, Xi, Wang, Jiao, Zhu, Lingyan, Liu, Jianying, Xu, Jixiong
• Format: Article
• Language: English
• Subjects: Febuxostat - therapeutic use; Gout Suppressants - therapeutic use; Humans; Hyperuricemia - complications; Hyperuricemia - drug therapy; Renal Insufficiency, Chronic - complications; Systematic Review and Meta-Analysis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000010161

To investigate the efficacy of febuxostat in hyperuricemic patients with chronic kidney disease (CKD), relevant randomized clinical trials (RCTs) were analyzed. 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. 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  = 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. 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.