title: Efficacy and safety of febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase for the treatment of hyperuricemia in kidney transplant recipients.
abstract: BACKGROUND
  Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase, is a potential alternative to allopurinol for patients with hyperuricemia. In this study, we evaluated the efficacy and safety of febuxostat for the management of hyperuricemia in renal transplant recipients.
  
  
  METHODS
  Between June 2012 and January 2013, a total of 22 renal transplant recipients (56 ± 10 years old) with hyperuricemia were enrolled in this study. All patients underwent de novo kidney transplantation, except for 1 patient, who received a second kidney transplant. Ten patients receiving allopurinol and 3 patients receiving benzbromarone were converted to febuxostat at doses of 10-20 mg/d. In the remaining 9 patients, who did not have a history of other urate-lowering medications, febuxostat was initiated at a dose of 10 mg/d.
  
  
  RESULTS
  Uric acid levels after initiation of febuxostat were significantly lower than before treatment (5.7 ± 0.7 mg/mL vs 8.0 ± 0.8 mg/mL; P < .001). At last follow-up visit, 16 of the 22 patients (73%) achieved uric acid levels of ≤ 6.0 mg/dL, despite the low dosage of febuxostat. All patients were maintained on febuxostat without serious adverse events, except for 1 patient, who discontinued febuxostat because of numbness in the arms.
  
  
  CONCLUSIONS
  Low-dose febuxostat is a promising alternative to allopurinol or benzbromarone for the treatment of hyperuricemia in kidney transplant recipients. The long-term urate-lowering efficacy and safety of febuxostat with regard to renal function in kidney transplant recipients with hyperuricemia requires further investigation.
authors.affiliation: Department of Transplant Surgery, International University of Health and Welfare, Atami Hospital, Shizuoka, Japan. Electronic address: tojimbara@iuhw.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Tojimbara
authors.affiliation: Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Nakajima
authors.affiliation: Department of Transplant Surgery, International University of Health and Welfare, Atami Hospital, Shizuoka, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Yashima
authors.affiliation: Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fuchinoue
authors.affiliation: Department of Transplant Surgery, International University of Health and Welfare, Atami Hospital, Shizuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Teraoka
mesh_terms: D000368:Aged; D000069465:Febuxostat; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
chemical_list: D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D014969:Xanthine Oxidase