Prevention of urolithiasis using febuxostat in patients with metabolic syndrome

• Published in: Urologii͡a︡ (Moscow, Russia : 1999) no. 3; p. 13
• Main Authors: Protoshchak, V V, Paronnikov, M V, Babkin, P A, Sleptsov, A V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01.07.2023
• Subjects: Febuxostat - therapeutic use; Humans; Metabolic Syndrome - complications; Metabolic Syndrome - drug therapy; Uric Acid - urine; Urinary Calculi - drug therapy; Urolithiasis - drug therapy; Urolithiasis - prevention & control; metabolic syndrome; urolithiasis; hyperuricemia; stone prevention; Febuxostat-SZ
• ISSN: 1728-2985
• DOI: 10.18565/urology.2023.3.13-20

Urolithiasis is a chronic highly recurrent disease. The development of new methods of its pathogenetic treatment and prevention is a priority task of practical urology. To evaluate the clinical efficiency and safety of Febuxostat-SZ and to develop the rec-ommendations for its use in patients with uric acid stones. The analysis of 525 patients with urolithiasis was carried out. On the basis of a comprehensive examination, they were divided into two groups: in the group 1, pa-tients (n=231) had urolithiasis and metabolic syndrome, while in the group 2 (n=294), only urolithia-sis was diagnosed without metabolic syndrome. In both groups, depending on the stone composi-tion, in addition to general measures, specific stone prevention was carried out, which included die-tary regimen and drug therapy. Uric acid excretion after 6 months of therapy in patients with urolithiasis and meta-bolic syndrome decreased from 9.8+/-1.8 to 3.9+/-1.1 mmol/l, urinary excretion of citrates and urine acidity increased from 0.8 +/-0.6 to 2.5+/-0.8 mmol/l and from 5.4+/-0.5 to 6.3+/-0.5, respectively, while serum uric acid level decreased from 451.4+/-15.1 up to 385.2+/-16.2 mmol/l. In the group of patients who, in addition to prescribing stone prevention, underwent correction of the metabolic syndrome, uric acid excretion after 3 months decreased by half: from 9.7+/-1.9 to 5.0+/-1.2 mmol/l, urine pH and citrate excretion increased from 5.4+/-0.4 to 6.3+/-0.5 and from 0.8+/-0.5 to 2.3+/-1.0 mmol/l, respective-ly, while serum uric acid level decreased from 459.5+/-17.7 to 370.9+/-15.1 mmol/l after 6 months of treatment. The use of Febuxostat-SZ in the complex therapy of urinary stone disease showed high efficiency in normalizing urine acidity, the level of daily excretion and serum uric acid level, as well as satisfactory tolerability and a minimal profile of side effects.