A Meta-Analysis for Comparing the Effects of Febuxostat and Allopurinol on Kidney Function in Hyperuricemia Patients Complicated with Chronic Kidney Disease

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Yu Wang, Kai Chen, Su-ya Zhou, Zi-xuan Qiao, Xiao-rong Bao
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Abstract

Background. This study was designed to assess the effects of febuxostat on the uric acid level and kidney function of hyperuricemia (HUA) patients complicated with chronic kidney disease (CKD). Methods. A computer-based search was conducted on the China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, and Web of Science databases from the inception of the databases to April 2023 to identify clinical randomized controlled trials on HUA and CKD, with comparisons between febuxostat and allopurinol as variables of interest. The meta-analysis was conducted using Stata v17.0. Results. Eighteen studies were included in this meta-analysis, encompassing a total of 1877 patients. These patients were segregated into a control group (treated with allopurinol or placebo) consisting of 1039 individuals and an experimental group (treated with febuxostat alone or a combination of febuxostat with other therapies) comprising 838 patients. The meta-analysis revealed that patients in the experimental group, treated with febuxostat, exhibited a significantly higher estimated glomerular filtration rate (eGFR) than those in the control group treated with allopurinol (weighted mean difference (WMD): 2.897, 95% CI: 1.336 to 4.458, P  < 0.001). In addition, the experimental group demonstrated significantly lower levels of serum creatinine (WMD: −17.810, 95% CI: −24.147 to −11.474, P  < 0.001), serum uric acid (WMD: −91.891, 95% CI: −117.609 to −66.173, P  < 0.001), and blood urea nitrogen (WMD: −1.284, 95% CI: −1.837 to −0.731, P  < 0.001). However, there was no significant difference in 24-hour urinary protein quantity (WMD: −0.198, 95% CI: −0.413 to 0.016, P  = 0.070) between the two groups. Conclusion. These findings suggest that febuxostat may offer a more beneficial therapeutic option for managing CKD in hyperuricemic patients. However, the observed heterogeneity and the limited diversity of the study population warrant cautious interpretation of these results.
比较非布索坦和别嘌醇对并发慢性肾病的高尿酸血症患者肾功能影响的 Meta 分析
研究背景本研究旨在评估非布索坦对并发慢性肾脏病(CKD)的高尿酸血症(HUA)患者尿酸水平和肾功能的影响。研究方法在中国国家知识基础设施(CNKI)、万方数据库、PubMed数据库和Web of Science数据库中进行计算机检索,检索时间从数据库建立之初至2023年4月,以非布索坦和别嘌醇之间的比较为研究变量,确定有关HUA和CKD的临床随机对照试验。荟萃分析使用 Stata v17.0 进行。分析结果本次荟萃分析共纳入了 18 项研究,涉及 1877 名患者。这些患者被分为对照组(接受别嘌醇或安慰剂治疗)和实验组(接受非布司他单独治疗或非布司他与其他疗法联合治疗),对照组有 1039 人,实验组有 838 人。荟萃分析显示,接受非布司他治疗的实验组患者的估计肾小球滤过率(eGFR)明显高于接受别嘌醇治疗的对照组患者(加权平均差(WMD):2.897,95% CI:1.336 至 4.458,P < 0.001)。此外,实验组的血清肌酐(WMD:-17.810,95% CI:-24.147 至 -11.474,P <0.001)、血清尿酸(WMD:-91.891,95% CI:-117.609 至 -66.173,P <0.001)和血尿素氮(WMD:-1.284,95% CI:-1.837 至 -0.731,P <0.001)水平均显著降低。然而,两组 24 小时尿蛋白量无明显差异(WMD:-0.198,95% CI:-0.413 至 0.016,P = 0.070)。结论这些研究结果表明,非布司他可能是治疗高尿酸血症患者慢性肾脏病的一种更有益的选择。然而,由于观察到的异质性和研究人群的多样性有限,因此需要谨慎解释这些结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
226
审稿时长
6 months
期刊介绍: The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.
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