J Rheum Dis 2019; 26(2): 118-123  
Comparison of Efficacy and Safety of Febuxostat in Gout Patients with Chronic Kidney Disease Stage 3 and Stage 4/5
Eeunyoung Ahn1, Sunggun Lee2, Han-Na Lee3, Seung-Geun Lee3, Min Wook So1
1Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, 2Division of Rheumatology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, 3Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
Correspondence to: Min Wook So http://orcid.org/0000-0001-5027-0410
Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. E-mail:thalsdnrso@naver.com
Received: November 23, 2018; Revised: December 13, 2018; Accepted: December 14, 2018; Published online: April 1, 2019.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective. To compare efficacy and safety of febuxostat in gouty patients with chronic kidney disease (CKD) stage 3 and stage 4/5. Methods. Age and sex matched patients with CKD stage 3 and stage 4/5 who were diagnosed with gout were included. The dose of febuxostat was increased according to serum uric acid (sUA) level. Adherence, the number of gout attack, the change of sUA, the change of estimated glomerular filtration rate (eGFR) and adverse events (AEs) were evaluated for 12 months. Results. There were no significant differences in the baseline variables between CKD stage 3 and CKD stage 4/5. Disease duration was longer and baseline sUA was higher in the CKD stage 4/5. There were no significant differences in the mean sUA at the last follow-up, the number of patients who reached the sUA target of 6 mg/dL and the number of gout attack between the groups. There were no significant differences in the change of eGFR and decrease of eGFR between the groups. There were 2 cases of AEs. One patient in CKD stage 3 had maculopapular rash and one patient in CKD stage 4/5 had dizziness. The AEs were subsided after febuxostat was stopped. Conclusion. Febuxostat was efficacious and well tolerated in gout patients with CKD stage 4/5.
Keywords: Gout, Febuxostat, Chronic kidney disease


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