The effect of low-dose febuxostat on arterial stiffness in elderly patients with asymptomatic hyperuricemia: A prospective, longitudinal cohort study.

BACKGROUND AND AIMS: Whether uric acid-lowering therapy improves arterial stiffness (AS) still remain controversial. This study aimed to evaluate the effect of low-dose febuxostat on AS in elderly patients with asymptomatic hyperuricemia (HUA) and chronic kidney disease (CKD).

METHODS AND

RESULTS

A total of 102 elderly patients (mean age 89.20 ± 3.20 years) were enrolled in this prospective cohort study and assigned to either a low-dose (20 mg/day), a normal-dose (40 mg/day), or a control group (lifestyle intervention). All patients underwent evaluations at baseline and the 3rd, 6th and 9th months. The primary endpoints were changes in SUA and brachial-ankle pulse wave velocity (baPWV). Multivariate analysis of variance was used for statistical analysis. Compared with those in control group, the SUA levels in both treatment groups fell to the lowest point at the 3rd month and remained low until the end of the study (intergroup, time, intergroup∗time; P < 0.001). Similarly, the baPWV in both treatment groups decreased by the 3rd month, followed by a gradual increase, and finally returned to the baseline levels (intergroup P = 0.003, time P = 0.487, intergroup∗time P = 0.872). Post-hoc multiple comparisons revealed significant differences in baPWV between each treatment group and the control group (low-dose vs. control: P = 0.001; normal-dose vs. control: P = 0.015), whereas no significant difference was observed between the two treatment groups (P = 0.374). No serious adverse events (AEs) were reported, but three gout attacks occurred in the normal-dose group.

CONCLUSIONS

Low-dose febuxostat demonstrated comparable urate-lowering efficacy to the normal-dose regimen and was also associated with a short-term improvement in arterial stiffness in elderly patients with asymptomatic HUA and CKD.