Therapeutic Research

Abstract

Background：Recently, hyperuricemia has been reported to be a risk factor for cardiovascular diseases and renal dysfunction, but their relationships have not been fully elucidated. In some intervention trials, existing xanthine oxidase（XO） inhibitors showed the renoprotective effect and inhibited cardiovascular events. However, some results suggest that each XO inhibitor has different activity on pulse wave velocity （PWV）. Topiroxostat, a novel XO inhibitor, showed an albuminuria‒lowering effect in a double‒blind study, but evidence from vascular system is limited. In this study, we evaluated the effects of topiroxostat on renal function and cardiovascular disease. Methods：Thirty two patients with hyperuricemia at high risk of cardiovascular disease were given topiroxostat. Of these, two were changed from allopurinol to topiroxostat, and twenty one were from febuxostat. We examined the serum uric acid（UA）and renal function markers（serum creatinine, estimated glomerular filtration rate（eGFR）, urinary albumin‒to‒creatinine ratio（ACR）, oxidized low‒density lipoprotein（ox‒LDL）,high sensitive C‒reactive protein（hs‒CRP）, brain natriuretic peptide（BNP）and blood pressure（BP）. Results：Topiroxostat significantly improved UA, ACR, hs‒CRP, BNP and BP. Additionally, it demonstrated the tendency of improvement in eGFR. Conclusion：These results suggest that topiroxostat has not only the hypouricemic action but also the renoprotective and anti‒atherogenic effects in patients with hyperuricemia at high‒risk cardiovascular disease.