薬理と治療

Abstract

Background　Recently, hyperuricemia is associated to be a risk factor for not only gouty arthritis but also renal dysfunction and cardiovascular events. Therefore, targeting to uric acid is very important therapeutic approaches to prevent for renal dysfunction and cardiovascular events. Topiroxostat, a selective xanthine oxidereductase inhibitor, showed an albuminuria-lowering effect in a double-blind study. In this retrospective study, we evaluated the efficacy and safety of topiroxostat administration in real-world. Methods　Eighty three patients with hyperuricemia were given topiroxostat in past. Of these, sixty two were newly administration, seventeen were switched from allopurinol to topiroxostat, and three were switched from febuxostat to topiroxostat. We examined the primary endpoint;L-FABP（L-FABP concentration and L-FABP/Cre）, secondary endpoints; serum uric acid （SUA）and renal function markers（urinary albumin and urinary albumin-to-creatinine ratio （ACR）, urinary β2－microglobulin（β2-MG）, N-acetyl-β-D-glucosaminidase（NAG））, lipid markers（TC, LDL-C）, intima-media thickness （IMT）. Results　After 24 weeks, topiroxostat administration resulted in significant reduction in SUA and urinary albumin, ACR, β2-MG, TC, LDL-C, tendency to reduce in NAG compared with baseline values. On the other hand, L-FABP did not change significantly. Conclusion　These results suggest that topiroxostat has not only the hypouricemic effect but also the renoprotective and lipid-lowering effects in patients with hyperuricemia. UMIN-CTR number：UMIN000023584