Treatment efficacy of febuxostat compared with allopurinol in hyperuricemia patients with hypertensive: A randomized, single-blind controlled trial

• Published in: Journal of applied pharmaceutical science
• Main Authors: Tran, Son Kim, Huynh, Binh Thanh, Tan Vo, Cuong, Ngo, Truyen Van, Thai Tran, Bao Lam, Dang Tran, Khoa Dang, Vo, Phuong Minh, Nguyen, Diem Thi, Ngo, Toan Hoang, Tran, An Viet
• Format: Journal Article
• Language: English
• Published: 2024
• ISSN: 2231-3354; 2231-3354
• DOI: 10.7324/JAPS.2024.173593

Treatment of hyperuricemia with allopurinol and Febuxotate has been shown to be effective in hypertensive patients. Studies comparing the effects of both drugs in hypertensive patients were very limited, especially in the Vietnam population. Evaluating the treatment outcome of febuxostat when compared with allopurinol in hyperuricemia patients with hypertension in Vietnam. We conducted a randomized controlled clinical trial with an allocation ratio of 1:2 on 108 hyperuricemia outpatients with hypertension ≥40 years old. Group A was treated with allopurinol 100 mg, increased to 300 mg if treatment results were not achieved. Group B used febuxostat 40 mg, which increased to 80 mg. The endpoint was to control serum uric acid levels <6.0 mg/dl (<360 μmol/l). Primary outcomes were re-evaluated after 4 and 8 weeks, comparing the reaching endpoint proportion between the two groups. The secondary outcomes were subgroup analysis on characteristic groups of age, gender, and serum lipid indices such as non-HDL-c and triglyceride (TG)/non-HDL-c ratio to evaluate the impact on treatment outcomes within and between two groups. The primary outcomes evaluating the effectiveness between the two regimens showed that the uric acid concentrations after 4 weeks in groups A and B were 343.5 ± 104.0 and 378.0 ± 90.0 μmol/l, respectively (p = 0.008), after 8 weeks it was 268.0 ± 97.8 and 310.0 ± 52.8 μmol/l (p < 0.001). After 8 weeks of intervention, the reaching endpoint proportion in the A and B groups was 91.7% and 97.1%, respectively [risk ratio (RR) = 1.06, 95% confidence interval (CI) 0.97–1.16, p = 0.297]. The secondary outcome was analized subgroup showed that there was a statistically significant difference when comparing group A and group B at age <60 (p = 0.020), male gender (p = 0.021), non-HDL ≥ 3.37 (p = 0.042), TG/HDL-c < 4.5 (p = 0.006), in which the allopurinol group showed more optimal serum uric acid lowering results. Both regimens had good outcomes in the ability to reduce serum uric acid and a high proportion of reaching endpoints. Therefore, it could be applied in the clinical of treating hyperuricemia patients with hypertension in Vietnam. When analyzed between the two groups, there was no large difference in treatment outcomes between the two regimens, so preference among the two regimens was not necessary.