Researchers in a recent study have found that febuxostat, a medication commonly used for gout management, is associated with a decreased risk of kidney events and a slower decline in estimated glomerular filtration rate (eGFR) in patients with gout. This finding addresses existing questions regarding the outcomes of febuxostat therapy in this patient population. Febuxostat, approved by the US Food and Drug Administration (FDA) in 2009 for the management of hyperuricemia in patients with gout, has been a stable therapy option. However, questions remained regarding its potential to delay the progression of kidney dysfunction and reduce kidney events.

This study was conducted by Yang XH and was published in Annals of Medicine. The study conducted a meta-analysis of 16 RCTs, analyzing data from various sources, including MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Randomized Controlled Trials. The key findings of the study were as follows:
• Febuxostat demonstrates renoprotective effects in patients with gout, potentially delaying the progression of kidney function deterioration.
• A meta-analysis of 16 randomized controlled trials (RCTs) revealed that patients receiving febuxostat had a reduced risk of kidney events and a slower decline in eGFR compared to controls.
• Compared to controls, patients treated with febuxostat showed a reduced risk of kidney events (relative risk [RR], 0.56) and a slower decline in eGFR (weighted mean difference [WMD], 0.90 mL/min/1.73 m2).
• Febuxostat use was also associated with a decrease in urine albumin to creatinine ratio (standardized mean difference [SMD], -0.21).
• Notably, febuxostat therapy was not associated with increased risks of all-cause mortality, death from cardiovascular disease, or cardiovascular events, despite previous safety concerns.
The findings suggest that febuxostat may be an effective drug for delaying the progression of kidney function deterioration in patients with gout or hyperuricemia. However, further research, including larger multicenter trials with hard kidney endpoints, is needed to validate these results.
Febuxostat demonstrates renoprotective effects in patients with gout, with a decreased risk of kidney events and a slower decline in eGFR compared to controls. Despite previous safety concerns, febuxostat therapy was not associated with increased risks of all-cause mortality or cardiovascular events. These findings highlight the potential of febuxostat as a treatment option for patients with gout or hyperuricemia.
Reference:
Yang XH, Zhang BL, Cheng Y, Fu SK, Jin HM. Febuxostat provides renoprotection in patients with hyperuricemia or gout: a systematic review and meta-analysis of randomized controlled trials. Ann Med. 2024;56(1):2332956. doi:10.1080/07853890.2024.2332956