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  • Brief Communication
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Febuxostat and renal outcomes: post-hoc analysis of a randomized trial

Hypertension Research volume 46, pages 1417–1422 (2023)Cite this article

A Comment to this article was published on 08 March 2023

Abstract

Effect of urate-lowering on renal outcomes in patients at high-risk for cardiovascular disease with hyperuricemia without gout is not known. We conducted a post hoc analysis of a randomized trial (Febuxostat for Cerebral and　CaRdiorenovascular Events PrEvEntion StuDy [FREED]). The FREED trial enrolled 1070 asymptomatic, hyperuricemic elderly patients with at least one risk factor for cardiovascular disease, divided into febuxostat (n = 537) and non-febuxostat (n = 533) groups. We compared the effect of these treatments on renal outcomes including 40% decline in estimated glomerular filtration rate, new onset of microalbuminuria and development or worsening macroalbuminuria. The relative risk of developing or worsening macroalbuminuria was 56% lower in the febuxostat group (hazard ratio, 0.44; 95% CI, 0.24–0.82; P = 0.0098). However, the risks for other outcomes were comparable. In patients with asymptomatic hyperuricemia without gout, febuxostat reduces the risk of development or worsening of macroalbuminuria.

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Funding

Funding for this study was provided by Teijin Pharma Limited, Japan.

Author information

Authors and Affiliations

  1. Dialysis Unit, University of the Ryukyus Hospital, Nishihara, Japan

    Kentaro Kohagura

  2. Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital, Yatsushiro, Japan

    Sunao Kojima

  3. Uchiyama Clinic, Joetsu, Japan

    Kazuaki Uchiyama

  4. Yokota Naika, Miyazaki, Japan

    Naoto Yokota

  5. Tokutake Iin, Kawaguchi, Japan

    Eiichi Tokutake

  6. Wakasa Medical Clinic, Kanazawa, Japan

    Yutaka Wakasa

  7. Hiramitsu Heart Clinic, Nagoya, Japan

    Shinya Hiramitsu

  8. Shizuoka City Shizuoka Hospital, Shizuoka, Japan

    Masako Waki

  9. Jinnouchi Hospital Diabetes Care Center, Kumamoto, Japan

    Hideaki Jinnouchi

  10. Kakuda Iin, Kahoku, Japan

    Hirokazu Kakuda

  11. Hayashi Medical Clinic, Sakai, Japan

    Takahiro Hayashi

  12. Kawai Naika Clinic, Gifu, Japan

    Naoki Kawai

  13. Sugawara Clinic, Tokyo, Japan

    Masahiro Sugawara

  14. Fuji Health Promotion Center, Fuji, Japan

    Hisao Mori

  15. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Kenichi Tsujita

  16. Department of Community, Family, and General Medicine, Kumamoto University Hospital, Kumamoto, Japan

    Kunihiko Matsui

  17. Institute of Regenerative Medicine and Biofunction, Tottori University Graduate School of Medical Science, Yonago, Japan

    Ichiro Hisatome

  18. Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan

    Yusuke Ohya

  19. Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan

    Kazuo Kimura

  20. Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan

    Yoshihiko Saito

  21. Kumamoto University, Kumamoto, Japan

    Hisao Ogawa

Authors
  1. Kentaro Kohagura
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  2. Sunao Kojima
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  3. Kazuaki Uchiyama
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  4. Naoto Yokota
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  5. Eiichi Tokutake
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  6. Yutaka Wakasa
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  7. Shinya Hiramitsu
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  8. Masako Waki
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  9. Hideaki Jinnouchi
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  10. Hirokazu Kakuda
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  11. Takahiro Hayashi
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  12. Naoki Kawai
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  13. Masahiro Sugawara
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  14. Hisao Mori
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  15. Kenichi Tsujita
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  16. Kunihiko Matsui
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  17. Ichiro Hisatome
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  18. Yusuke Ohya
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  19. Kazuo Kimura
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  20. Yoshihiko Saito
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  21. Hisao Ogawa
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Consortia

on behalf of the Febuxostat for Cerebral and Cardiorenovascular Events Prevention Study (FREED) investigators

Corresponding author

Correspondence to Kentaro Kohagura.

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Conflict of interest

KK reports personal fees for lecture from Teijin Pharma, Fuji Pharma, Sanwa Kagaku, Pfizer, and Mochida Pharma, and research funding from Teijin Pharma, outside the submitted work. SK reports other support from Teijin Home Healthcare Limited and grants from Philips Respironics Goudou Kaisha, Teijin Pharma Limited, Daiichi Sankyo Company, Limited, and Chugai Pharmaceutical Company, Ltd. outside the submitted work. IH reports grants and personal fees from Sanwa Kagaku Kenkyusho Co., Ltd. and Fuji Yakuhin Co., Ltd., personal fees from Pfizer Japan, Inc., and grants from Sumitomo Dainippon Pharma Co., Ltd. and Teijin Pharma Limited outside the submitted work. KK reports grants from Teijin Pharma Limited and personal fees from Mitsubishi Tanabe Pharma Corporation outside the submitted work. YS reports grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan, the Ministry of Health, Labor and Welfare Scientific Research, and the Japan Agency for Medical Research and Development during the conduct of the study and grants and personal fees from Astellas Pharma Inc., Daiichi Sankyo Company, Limited, Sumitomo Dainippon Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sanofi K.K., Takeda Pharmaceutical Company Ltd., and Nippon Boehringer Ingelheim Co., Ltd., grants from Boston Scientific Japan K.K., Chugai Pharmaceutical Company, Ltd., Eisai Co., Ltd., Fuji Yakuhin Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Medtronic Japan Co., Ltd., Nihon Medi-Physics Co., Ltd., Shionogi & Co., Ltd., Teijin Pharma Limited, ZERIA Pharmaceutical Co., Ltd., and St. Jude Medical Japan Co., Ltd., grants, personal fees and other support from MSD K.K., and personal fees from Asahi Kasei Pharma Corporation, Bayer Holding Ltd., Kowa Pharmaceutical Co., Ltd., Novartis Pharma K. K., Taisho Toyama Pharmaceutical Co., Ltd., and Toa Eiyo Ltd. Outside the submitted work. The remaining authors have no competing interests to declare.

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Kohagura, K., Kojima, S., Uchiyama, K. et al. Febuxostat and renal outcomes: post-hoc analysis of a randomized trial. Hypertens Res 46, 1417–1422 (2023). https://doi.org/10.1038/s41440-023-01198-x

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