Efficacy and Safety of Fenofibrate in Patients with Hyperuricemia
Keywords:
Fenofibrate, uric acid, hyperuricemiaAbstract
Background: Allopurinol is the most frequently used antihyperuricemic drug. Fenofibrate, a derivative of fibric
acid, is commonly used in the treatment of hyperlipidemia. Fenofibrate treatment has been shown to decrease
serum uric acid levels. This study was conducted to assess the efficacy and safety of fenofibrate in patients with
hyperuricemia.
Material and Method:
Sixty hyperuricemic patients with serum uric acid level 7.0mg per deciliter or above were enrolled and assigned to take either allopurinol 300mg or fenofibrate 200mg daily for 12 weeks. Drug
efficacy was assessed by measuring percentage of subjects achieving serum uric acid level less than 6mg per
deciliter at day 90. Drug efficacy was also assessed by measuring percent change in serum uric acid level from
day 0 to day 90. Safety of the drug was assessed by reviewing adverse effects (AEs) and laboratory values.
Results:
Comparison of percentage of subjects reaching serum uric acid level less than 6.0mg per deciliter at
day 90 between the two groups was significant (P=0.14). However, percent change in serum uric acid level from
day 0 to day 90 was highly significant between the two groups (P=0.001). Proportions of subjects experiencing
any adverse event were higher in fenofibrate group, though the adverse effects leading to treatment withdrawal
were higher in allopurinol group.
Conclusion: Fenofibrate 200mg once daily is an effective antihyperuricemic agent.
Downloads
References
Dincer H E, Dincer A P, Levinson D J. Asymptomatic hyperuricemia: To treat or not to treat. Cleveland Clinic Journal Of Medicine 2002; 69 (8): 594-608.
So Alexander. Developments in the scientific and clinical understanding of gout. Arthritis Research & Therapy 2008; 10 (5): 1-6.
Becker MA, Schumacher HR, Wortmann RL, MacDonald P A, Eustace D, Palo W A, Streit J and Joseph-Ridge N. Febuxostat Compared with Allopurinol in Patients with Hyperuricemia and Gout. N Engl J Med 2005; 353: 2450-61.
Sunkureddi P, Nguyen-Oghalai T U, Karnath B M. Clinical Signs of Gout. Hospital Physician January 2006; 47: 39–42.
Akkasilpa S, Osiri M, Deesomchok U, Avihingsanon Y. The efficacy of combined low dose of Allopurinol and Benzbromarone compared to standard dose of Allopurinol in hyperuricemia. J Med Assoc Thai 2004; 87(9): 1087-91.
Cannella A C, Mikuls T R. Understanding Treatments for Gout. Am J Manag Care 2005; 11: 451-458.
Preitner F, Bonny O, Laverrie` re A, Rotman S, Firsov D, Da Costa A, Metref S, Thorens B. Glut9 is a major regulator of urate homeostasis and its genetic inactivation induces hyperuricosuria and urate nephropathy. PNAS 2009; 106 (36): 15501–15506.
Goldenberg I, Benderly M and Goldbourt U. Update on the use of fibrates: focus on bezafibrate. Vascular Health and Risk Management 2008; 4 (1): 131–141.
Mooreland LW. Febuxostat Treatment for Hyperuricemia and Gout? n engl j med 2005; 353: 2433-41.
Schumacher HR, Becker MA, Lloyd E, MacDonald, Lademacher C. Febuxostat in the treatment of gout: 5-yr findings of the Focus efficacy and safety study. Rheumatology 2009; 48: 188–194.
Kuang-Hui Yu. Febuxostat: A novel non-purine selective inhibitor of xanthine oxidase for the treatment of hyperuricemia in gout. Recent patents on inflammation & allergy drug discovery 2007; 1: 69-75.
Neogi T, Gout. N Engl J Med 2011; 364: 443-52.
Terkeltaub R A. Gout. N Engl J Med 2003; 349: 1647- 55.
Feher M. D., Hepburn A. L., Hogarth M. B., Ball S. G. and Kaye S. A.: Fenofibrate enhances urate reduction in men treated with allopurinol for hyperuricaemia and gout. Rheumatology 2003; 42: 321–325.
Emmerson B T. The Management Of Gout. The New England Journal of Medicine 1996; 334 (7): 445-451.
Hepburn A L. Fenofibrate: A New Treatment For Hyperuricaemia And Gout? Ann Rheum Dis 2001; 60: 984–992.
Wei L, Mackenzie IS, Chen Y, Struthers AD, MacDonald TM. Impact of allopurinol use on urate concentration and cardiovascular outcome. Br J Clin Pharmacol 2010; 71 (4): 600-607.
Danis R, Akbulut S, Ozmen S, Arikan S. Danis R, Akbulut S, Ozmen S, Arikan S. RhabdomyolysisInduced Acute Renal Failure Following Fenofibrate Therapy: A Case Report and Literature Review. 2010; 2010: 1-3.
Bardin T. Fenofibrate and Losartan. Ann Rheum Dis 2003; 62: 497–498.
Schumacher HR, Becker MA, Wortmann RL, Patricia A. Macdonald PA, Barbara Hunt B, Streit J, Lademacher C, Nancy J R. Effects of Febuxostat versus Allopurinol and Placebo in Reducing Serum Urate in Subjects with Hyperuricemia and Gout: A 28-Week, Phase III Randomized, Double-Blind, Parallel-Group Trial. Arthritis & Rheumatism. Arthritis Care & Research 2008; 59 (11): 1540–1548.
Takahashi S, Moriwaki Y, Yamamoto T, Tsutsumi Z, Ka T, Fukuchi M. Effects of combination treatment using anti-hyperuricaemic agents with fenofibrate and/or losartan on uric acid metabolism. Ann Rheum Dis 2003; 62: 572–575.22 Lee YH, Lee CH, Lee J. Effect of Fenofibrate in
Combination with Urate Lowering Agents in Patients with Gout. The Korean Journal of Internal Medicine
; 21: 89-93.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Irfan Zafar, Moosa Khan, Syed Mohsin Turab, Rafeeq Alam Khanz
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal.