Skip to main content
Top
Published in: Clinical and Experimental Nephrology 6/2014

Open Access 01-12-2014 | Original Article

Effects of topiroxostat on the serum urate levels and urinary albumin excretion in hyperuricemic stage 3 chronic kidney disease patients with or without gout

Authors: Tatsuo Hosoya, Iwao Ohno, Shinsuke Nomura, Ichiro Hisatome, Shunya Uchida, Shin Fujimori, Tetsuya Yamamoto, Shigeko Hara

Published in: Clinical and Experimental Nephrology | Issue 6/2014

Login to get access

Abstract

Background

Topiroxostat, a selective xanthine oxidase inhibitor, shows effective reduction in the serum urate level in hyperuricemic patients with or without gout. The objective of this study was to evaluate the efficacy and safety of topiroxostat in hyperuricemic stage 3 chronic kidney disease patients with or without gout.

Methods

The study design was a 22-week, randomized, multicenter, double-blind study. The enrolled patients were randomly assigned to treatment with topiroxostat 160 mg/day (n = 62) or to the placebo (n = 61). The endpoints were the percent change in the serum urate level, change in the estimated glomerular filtration rate, the urinary albumin-to-creatinine ratio, the proportion of patients with serum urate levels of 356.88 μmol/L or less, blood pressure, and serum adiponectin.

Results

After 22 weeks, although the changes in the estimated glomerular filtration rate and blood pressure were not significant, the percent change in the serum urate level (−45.38 vs. −0.08 %, P < 0.0001) and the percent change in urinary albumin-to-creatinine ratio (−33.0 vs. −6.0 %, P = 0.0092) were found to have decreased in the topiroxostat as compared with the placebo. Although the incidence of ‘alanine aminotransferase increased’ was higher in the topiroxostat, serious adverse event rates were similar in the two groups.

Conclusion

Topiroxostat 160 mg effectively reduced the serum urate level in the hyperuricemic stage 3 chronic kidney disease patients with or without gout.
Literature
1.
go back to reference Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 2012;125:679–87.PubMedCrossRef Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 2012;125:679–87.PubMedCrossRef
2.
go back to reference Iseki K, Oshiro S, Tozawa M, et al. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res. 2001;24:691–7.PubMedCrossRef Iseki K, Oshiro S, Tozawa M, et al. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res. 2001;24:691–7.PubMedCrossRef
3.
go back to reference Chonchol M, Shlipak MG, Katz R, Sarnak M, et al. Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007;50:239–47.PubMedCrossRef Chonchol M, Shlipak MG, Katz R, Sarnak M, et al. Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007;50:239–47.PubMedCrossRef
4.
go back to reference Chang HY, Tung CW, Lee PH, et al. Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population. Am J Med Sci. 2010;339:509–15.PubMed Chang HY, Tung CW, Lee PH, et al. Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population. Am J Med Sci. 2010;339:509–15.PubMed
5.
go back to reference Yamanaka H, Japanese Society of Gout and Nucleic Acid Metabolism. Japanese guideline for the management of hyperuricemia and gout: second edition. Nucleosides Nucleotides Nucleic Acids. 2011;30:1018–29.PubMedCrossRef Yamanaka H, Japanese Society of Gout and Nucleic Acid Metabolism. Japanese guideline for the management of hyperuricemia and gout: second edition. Nucleosides Nucleotides Nucleic Acids. 2011;30:1018–29.PubMedCrossRef
6.
go back to reference Gagliardi AC, Miname MH, Santos RD. Uric acid: a marker of increased cardiovascular risk. Atherosclerosis. 2009;202:11–7.PubMedCrossRef Gagliardi AC, Miname MH, Santos RD. Uric acid: a marker of increased cardiovascular risk. Atherosclerosis. 2009;202:11–7.PubMedCrossRef
7.
go back to reference Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med. 2007;120:442–7.PubMedCrossRef Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med. 2007;120:442–7.PubMedCrossRef
10.
go back to reference Siu YP, Leung KT, Tong MK, et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47:51–9.PubMedCrossRef Siu YP, Leung KT, Tong MK, et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47:51–9.PubMedCrossRef
11.
go back to reference Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010;5:1388–93.PubMedCentralPubMedCrossRef Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010;5:1388–93.PubMedCentralPubMedCrossRef
12.
go back to reference Collins AJ, Foley RN, Chavers B et al. ‘United States Renal Data System 2011 Annual Data Report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Am J Kidney Dis. 2012; 59(1 Suppl 1):A7, e1–420. Collins AJ, Foley RN, Chavers B et al. ‘United States Renal Data System 2011 Annual Data Report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Am J Kidney Dis. 2012; 59(1 Suppl 1):A7, e1–420.
13.
go back to reference Okamoto K, Eger BT, Nishino T, et al. An extremely potent inhibitor of xanthine oxidoreductase. Crystal structure of the enzyme-inhibitor complex and mechanism of inhibition. J Biol Chem. 2003;278:1848–55.PubMedCrossRef Okamoto K, Eger BT, Nishino T, et al. An extremely potent inhibitor of xanthine oxidoreductase. Crystal structure of the enzyme-inhibitor complex and mechanism of inhibition. J Biol Chem. 2003;278:1848–55.PubMedCrossRef
14.
go back to reference Okamoto K, Matsumoto K, Hille R, et al. The crystal structure of xanthine oxidoreductase during catalysis: implications for reaction mechanism and enzyme inhibition. Proc Natl Acad Sci USA. 2004;101:7931–6.PubMedCentralPubMedCrossRef Okamoto K, Matsumoto K, Hille R, et al. The crystal structure of xanthine oxidoreductase during catalysis: implications for reaction mechanism and enzyme inhibition. Proc Natl Acad Sci USA. 2004;101:7931–6.PubMedCentralPubMedCrossRef
15.
go back to reference Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthr Care Res (Hoboken). 2012;64:1431–46.CrossRef Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthr Care Res (Hoboken). 2012;64:1431–46.CrossRef
16.
go back to reference Arellano F, Sacristán JA. Allopurinol hypersensitivity syndrome: a review. Ann Pharmacother. 1993;27:337–43.PubMed Arellano F, Sacristán JA. Allopurinol hypersensitivity syndrome: a review. Ann Pharmacother. 1993;27:337–43.PubMed
17.
go back to reference Emmerson BT, Gordon RB, Cross M, et al. Plasma oxipurinol concentrations during allopurinol therapy. Br J Rheumatol. 1987;26:445–9.PubMedCrossRef Emmerson BT, Gordon RB, Cross M, et al. Plasma oxipurinol concentrations during allopurinol therapy. Br J Rheumatol. 1987;26:445–9.PubMedCrossRef
18.
go back to reference Hande KR, Noone RM, Stone WJ. Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am J Med. 1984;76:47–56.PubMedCrossRef Hande KR, Noone RM, Stone WJ. Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am J Med. 1984;76:47–56.PubMedCrossRef
19.
go back to reference Dalbeth N, Kumar S, Stamp L, et al. Dose adjustment of allopurinol according to creatinine clearance does not provide adequate control of hyperuricemia in patients with gout. J Rheumatol. 2006;33:1646–50.PubMed Dalbeth N, Kumar S, Stamp L, et al. Dose adjustment of allopurinol according to creatinine clearance does not provide adequate control of hyperuricemia in patients with gout. J Rheumatol. 2006;33:1646–50.PubMed
20.
go back to reference Schumacher HR Jr, Becker MA, Wortmann RL, et al. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthr Rheum. 2008;59:1540–8.CrossRef Schumacher HR Jr, Becker MA, Wortmann RL, et al. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthr Rheum. 2008;59:1540–8.CrossRef
21.
go back to reference Curiel RV, Guzman NJ. Challenges associated with the management of gouty arthritis in patients with chronic kidney disease: a systematic review. Semin Arthr Rheum. 2012;42:166–78.CrossRef Curiel RV, Guzman NJ. Challenges associated with the management of gouty arthritis in patients with chronic kidney disease: a systematic review. Semin Arthr Rheum. 2012;42:166–78.CrossRef
22.
go back to reference Sato T, Ashizawa N, Matsumoto K, et al. Discovery of 3-(2-cyano-4-pyridyl)-5-(4-pyridyl)-1,2,4-triazole, FYX-051—a xanthine oxidoreductase inhibitor for the treatment of hyperuricemia (corrected). Bioorg Med Chem Lett. 2009;19:6225–9.PubMedCrossRef Sato T, Ashizawa N, Matsumoto K, et al. Discovery of 3-(2-cyano-4-pyridyl)-5-(4-pyridyl)-1,2,4-triazole, FYX-051—a xanthine oxidoreductase inhibitor for the treatment of hyperuricemia (corrected). Bioorg Med Chem Lett. 2009;19:6225–9.PubMedCrossRef
23.
go back to reference Matsumoto K, Okamoto K, Ashizawa N, et al. FYX-051: a novel and potent hybrid-type inhibitor of xanthine oxidoreductase. J Pharmacol Exp Ther. 2011;336:95–103.PubMedCrossRef Matsumoto K, Okamoto K, Ashizawa N, et al. FYX-051: a novel and potent hybrid-type inhibitor of xanthine oxidoreductase. J Pharmacol Exp Ther. 2011;336:95–103.PubMedCrossRef
24.
go back to reference Kosugi T, Nakayama T, Heinig M, et al. Effect of lowering uric acid on renal disease in the type 2 diabetic db/db mice. Am J Physiol Renal Physiol. 2009;297:F481–8.PubMedCentralPubMedCrossRef Kosugi T, Nakayama T, Heinig M, et al. Effect of lowering uric acid on renal disease in the type 2 diabetic db/db mice. Am J Physiol Renal Physiol. 2009;297:F481–8.PubMedCentralPubMedCrossRef
25.
go back to reference Omori H, Kawada N, Inoue K, et al. Use of xanthine oxidase inhibitor febuxostat inhibits renal interstitial inflammation and fibrosis in unilateral ureteral obstructive nephropathy. Clin Exp Nephrol. 2012;16:549–56.PubMedCrossRef Omori H, Kawada N, Inoue K, et al. Use of xanthine oxidase inhibitor febuxostat inhibits renal interstitial inflammation and fibrosis in unilateral ureteral obstructive nephropathy. Clin Exp Nephrol. 2012;16:549–56.PubMedCrossRef
26.
go back to reference Ng WY, Lui KF, Thai AC. Evaluation of a rapid screening test for microalbuminuria with a spot measurement of urine albumin-creatinine ratio. Ann Acad Med Singap. 2000;29:62–5.PubMed Ng WY, Lui KF, Thai AC. Evaluation of a rapid screening test for microalbuminuria with a spot measurement of urine albumin-creatinine ratio. Ann Acad Med Singap. 2000;29:62–5.PubMed
Metadata
Title
Effects of topiroxostat on the serum urate levels and urinary albumin excretion in hyperuricemic stage 3 chronic kidney disease patients with or without gout
Authors
Tatsuo Hosoya
Iwao Ohno
Shinsuke Nomura
Ichiro Hisatome
Shunya Uchida
Shin Fujimori
Tetsuya Yamamoto
Shigeko Hara
Publication date
01-12-2014
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 6/2014
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-014-0935-8

Other articles of this Issue 6/2014

Clinical and Experimental Nephrology 6/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.