非布索坦对痛风患者有多大的效果？

Clinical trials analyzed gout patients with moderate to severe renal insufficiency who, after one year of treatment with febuxostat, achieved target levels of serum uric acid without further deterioration in renal function. How effective is febuxostat for gout patients?

The study randomly divided patients into three groups, receiving febuxostat 30 mg twice a day, febuxostat 40/80 mg once a day, or placebo. After 12 months, compared with the placebo group, 68.8% of patients in the febuxostat 30 mg group had serum uric acid levels below 6 mg/dl; 45.2% in the 40/80 mg group. There was no significant difference in the changes in serum creatinine after 12 months between the experimental group and the placebo group: the mean least squares difference in serum creatinine in the 30 mg group was -0.10, and the mean least squares difference in serum creatinine in the 40/80 mg group was 0.04.

Therefore, to evaluate the efficacy of febuxostat in patients with renal failure and an estimated glomerular filtration rate of 15-50 ml/min/1.73 m2, Saag and colleagues analyzed 95 patients with a mean age of 66 years and a mean baseline serum uric acid level of 10.5 mg/dl. Among them, patients with severe renal dysfunction accounted for 37.5%, and patients with moderate renal dysfunction accounted for 62.5%. 38.5% of patients had serum creatinine below 2 mg/dl, 30.2% had serum creatinine between 2 and 2.5 mg/dl, and 31.3% had serum creatinine above 2.5 mg/dl. The majority of patients are male, and most suffer from hypertension and hyperlipidemia. Nearly half of the patients had diabetes.

In the 6th month of treatment, in the febuxostat 30 mg group, 65.6% of patients in the febuxostat 30 mg group had serum uric acid lower than the target value of 6 mg/dl, 51.6% in the 40/80 mg group, and 0 in the placebo group. There was no significant difference in the baseline change in estimated glomerular filtration rate at 12 months. The least squares mean of the febuxostat 30 mg group was 2.38 mL/min/1.73 m2, and febuxostat 40/80. The least squares mean of the mg group was 1.19.