title: Placebo-controlled double-blind dose-response study of the non-purine-selective xanthine oxidase inhibitor febuxostat (TMX-67) in patients with hyperuricemia (including gout patients) in japan: late phase 2 clinical study.
abstract: BACKGROUND
  Allopurinol has been widely used for the treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat has been identified as a potentially safe and efficacious alternative.
  
  
  OBJECTIVE
  A multicenter study with randomized, placebo-controlled, double-blind, parallel, intergroup comparison was carried out to evaluate the dose-response relationship, efficacy, and safety of febuxostat in 202 patients with hyperuricemia (including patients with gout) in Japan.
  
  
  METHODS
  The subjects were treated with febuxostat at fixed maintenance doses (20-80 mg/d) or a placebo for 16 weeks. The percentage of patients achieving serum uric acid levels 6.0 mg/dL or less and the percent change in serum uric acid levels after 16 weeks of treatment were evaluated.
  
  
  RESULTS
  The percentage of patients achieving serum uric acid levels 6.0 mg/dL or less at 16 weeks was 87.8% in the 80-mg/d dose group, 83.3% in the 60-mg/d group, 82.9% in the 40-mg/d group, 46.5% in the 20-mg/d group, and 2.6% in the placebo group (P < 0.001, Mantel-Haenszel test). A statistically significant dose-response relationship was found. The percent change in serum uric acid levels after 16 weeks of treatment differed significantly between each febuxostat dose group and the placebo group and increased in a dose-dependent manner above 40 mg/d. No deaths, events posing a clinical problem, or serious adverse reactions attributable to febuxostat were noted. Similar results were obtained regardless of gout history.
  
  
  CONCLUSIONS
  Febuxostat can safely reduce serum uric acid levels to 6.0 mg/dL or less in 80% or more of patients with hyperuricemia (including gout) at doses of 40 mg/d or higher.
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, Teikyo University, Tokyo, Japan. kamatani@msb.biglobe.ne.jp
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kamatani
authors.forename: Kamatani
authors.initials: K
authors.lastname: Naoyuki
authors.forename: Shin
authors.initials: S
authors.lastname: Fujimori
authors.forename: Fujimori
authors.initials: F
authors.lastname: Shin
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Hada
authors.forename: Hada
authors.initials: H
authors.lastname: Toshikazu
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
authors.forename: Hosoya
authors.initials: H
authors.lastname: Tatsuo
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
authors.forename: Kohri
authors.initials: K
authors.lastname: Kenjiro
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Nakamura
authors.forename: Nakamura
authors.initials: N
authors.lastname: Toshitaka
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.forename: Ueda
authors.initials: U
authors.lastname: Takanori
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yamamoto
authors.initials: Y
authors.lastname: Tetsuya
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Yamanaka
authors.initials: Y
authors.lastname: Hisashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
authors.forename: Matsuzawa
authors.initials: M
authors.lastname: Yuji
mesh_terms: D000284:Administration, Oral; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D000069465:Febuxostat; D005260:Female; D005500:Follow-Up Studies; D006073:Gout / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D013844:Thiazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
chemical_list: D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D014527:Uric Acid; D014969:Xanthine Oxidase