薬理と治療

Abstract

Although dotinurad, which is used to treat hyperuricemia, has been subjected to non–inferiority studies with febuxostat, there are few specific reports on the variation in uric acid levels after switching from febuxostat to dotinurad. Therefore, we investigated changes in uric acid levels in patients who switched from febuxostat or other xanthine oxidase inhibitors to dotinurad.　　We retrospectively extracted uric acid levels in serum before and after the switch from febuxostat to dotinurad from the electronic medical record system of patients attending Saiseikai Maebashi Hospital. In addition, we examined changes in uric acid levels in patients prospectively switched from febuxostat or allopurinol to dotinurad at a clinic affiliated with Takasaki University of Health and Welfare. Fluctuations in blood biochemical values before and after the switch were also investigated.　　In the six patients who switched from febuxostat 10 mg to dotinurad 0.5 mg, serum uric acid levels were controlled below 7.0 mg/dL at the first outpatient visit after the switch in two of six patients. Two of six patients had controlled uric acid levels below 7.0 mg/dL when they first visited the outpatient clinic after the switch. The remaining two patients, excluding the two who were followed–up observed, achieved a decrease to 7.0 mg/dL or less by increasing the dose of dotinurad to 1.0 mg or 2.0 mg.　　In patients who were prospectively switched from 10 mg of febuxostat or 100 mg of allopurinol to 0.5 mg of dotinurad, uric acid levels were within reference limits after the switch. In both studies, a trend toward improvement in hepatic function was observed in a few cases.　　Serum uric acid levels after switching from xanthine oxidase inhibitors to dotinurad were controllable by increasing the dosage of dotinurad and other measures, and no period of duplication or loss of drug effect due to the switch was observed. （Jpn Pharmacol Ther 2023；51：1403‒10）