Urate lowering drugs RandomIzed parallel-group Comparison study in the Chronic Kidney Disease patients with hypertension and hyperuricemia

JRCT ID: jRCTs071180033

Registered date:07/03/2019

Basic Information

• Recruitment status: Complete
• Health condition(s) or Problem(s) studied: Chronic kidney disease with hyperuricemia and hypertension
• Date of first enrollment: 16/10/2017
• Target sample size: 100
• Study type: Interventional
• Intervention(s): Examination of the effect of febuxostat and benzbromarone on renal function

Outcome(s)

• Primary Outcome: Rate of change in estimated GFR from baseline to 52 weeks

Secondary Outcome

1) Rate of change in eGFR from the baseline to 8 weeks
2) Rate of change in office blood pressure from the baseline to 8 and 52 weeks
3) Difference in rate of change in estimated GFR before(Visit 1 to 2) and after treatment (Visit 2 to 4)
4) Rate of change in serum uric acid from baseline to 8 and 52 weeks and achievement rate of serum uric acid concentration less than 6 mg/dl at 8 and 52 weeks
5) Rate of change in urinary albumin-to-creatine ratio from baseline to 8 and 52 weeks
6) Rate of change in urinary pH from baseline to 8 and 52 weeks
7) Rate of change in serum xanthine oxidase activity from baseline to 8 and 52 weeks
8) Rate of change in high sensitive C reactive protein from baseline to 8 and 52 weeks
9) Rate of change in 8-OHdG (8-hydroxy-2-deoxyguanosine) from baseline to 8 and 52 weeks
10) Rate of change in urinary angiotensinogen from baseline to 8 and 52 weeks
11) Rate of change in L type free fatty acid binding protein(L-FABP) from baseline to 8 and 52 weeks
12) Rate of change in estimated GFR from baseline to 52 weeks stratified by basal urinary albumin-to-creatinine ratio (300mg/gCr) or estimated GFR (45ml/min/1.73m2)

Key inclusion & exclusion criteria

• Age minimum: >= 20age old
• Age maximum: Not applicable
• Gender: Both

Include criteria

1) Serum uric acid >7.0 mg/dL
2) Patients with hypertension defined as blood pressure measurements of equal or more than 140 mm Hg systolic and/or equal or more than 90 mm Hg diastolic or treatment with antihypertensive agents. No changes in prescription of antihypertensive agent 8 weeks before initiating the study drug.
3) CKD stage 3a and 3b
4) Age equal to or more than 20 years at obtaining informed consent
5) Outpatient
6) No history of gout
7) Obtained written informed consent from the patient for participation to the study

Exclude criteria

1) History of hypersensitivity to febuxostat or benzbromarone
2) AST or ALT is more than twice the upper limit of institutional normal range
3) eGFR <30ml/min/1.73m2 or dialysis patients.
4) Under treatment with thiazide diuretics or loop diuretics
5) History of treatment with urate lowering drugs within 2 weeks before determination of eligibility
6) History of coronary heart disease within 3 month before determination of eligibility
7) Patients with neoplasm, History of neoplasm except for the cured patients without recurrence within 5 years before determination of eligibility
8) Under treatment with the following: mercaptopurine,azathioprine, pyrazinamide, ethanbutol
9) Under treatment with warfarin
10) Women who are or may be pregnant, or brest-feeding
11) Participants of other clinical trials within 6 month before determination of eligibility
12) Urolithiasis
13) A patient who are judged inadequate for enrollment by an attending physician
14) A patient whose serum uric acid level is equal to or less than 7 mg/dl at Visit2 after randomization
15) A patient has been suffered from any of following: acute myocardial infarction, acute coronary syndrome, patients undergoing percutaneous coronary intervention or coronary artery bypass grafting, vetricular tachycarida, mutifocal ventricular arrhythmia and acute heart failure within three months before the eligibility assessment. This exclusion criteria was added since recent study suggested febuxostat may be associated with increased cardiovascular mortality compared with allopurinol among gout patients with major cardiovascular disease (N Engl J Med 2018;378:1200-10)

Related Information

• Primary Sponsor: Kohagura Kentaro
• Secondary Sponsor: TEIJIN PHARMA LIMITED
• Secondary ID(s): UMIN000026847