The Efficacy And Safety Of Febuxostat In Treatment Of Chronic Kidney Disease Patients With Hyperuricemia

Objective:By means of system evaluation and META analysis,we focused on the efficacy and safety of the Febuxostat on the CKD patients with HUA,in order to evaluate its ULT,kidney protection and the tolerance of the patients.We hope it will assist the clinicians to provide patients with more accurate therapy and make better prognosis.Materials and Methods:We searched Cochrane Library,MEDLINE,EMBASE,CNKI,WANFANG databases for randomized controlled trial of ULT for CKD with HUA patients,comparing febuxostat with Allopurinol or placebo.The data analyses were done by RevMan 5.3 software and got access to conclusion.Result:Our meta-analysis contained 8 articles,including 10 RCTs,involving 1081 patients.There were 6 high-quality and 2 low-quality articles.The effectiveness analysis showed that compared with the placebo group,SUA decreased more significantly and eGFR improved more,in the Febuxostat group,and the difference was statistically significant(p<0.05).Compared with the Allopurinol group,the Febuxostat group showed a greater decrease in SUA,a higher target rate of uric acid and a more significant improvement in eGFR,with statistically significant differences(p<0.05).Safety analysis:compared with the placebo group,the incidence of adverse reactions of gastrointestinal reactions,elevated aminotransferase,joint pain and musclepain in the Febuxostat group were similar,while the incidence of renal function deterioration was lower(p<0.01).The overall incidence of adverse reactions was similar in the Febuxostat group compared with the Allopurinol group.There was merely migration risk in both funnel maps of the effectiveness and safety analysis.Conclusion:In this systematic evaluation,META analysis shows that Febuxostat has a significant effect on reducing uric acid,and its efficacy is more significant with the placebo group.Compared with Allopurinol group,both the uric acid lowering and the target rate of uric acid show better efficacy.Febuxostat has protective effect of kidney and better than Allopurinol.There are no significant differences in the adverse reactions compared with both placebo and Allopurinol group,and the incidence of renal injury events in Febuxostat group was lower than that in the placebo group.