- 期刊
探討Febuxostat在痛風高尿酸血症病人的療效和安全
Efficacy and Safety of Febuxostat in Patient with Hyperuricaemia and Gout
摘要
目的：痛風高尿酸血症傳統降尿酸藥allopurinol常引起過敏之藥物不良反應，而febuxostat是一種非嘌呤類黃嘌呤氧化酶(xanthine oxidase)選擇性抑制劑， 可降低血清尿酸達到治療作用且肝腎功能不全者不需調整劑量。本研究目標探討新藥febuxostat 80 mg/tab，對治療痛風的療效及安全性評估。方法：以回溯性方法收集2013年4月至2014年3月間，診斷碼為（ICD-9-CM2740：痛風性關節炎病變，2749：痛風）共收集115位病人改用febuxostat後，追蹤血清尿酸值的變化及副作用，將所收集資料以SPSS 17進行資料分析。結果：男性病人有86位(74.8%)，女性29位(25.2%)，平均年齡61.7 ± 17.1歲。病人除痛風外併有腎臟疾病占最多，有82人(71.2%)，其次是併高血壓有54人(47%)。病人改用febuxostat治療前，以服用 allopurinol治療高尿酸血症有27人(23.4%)和allopurinol 併用colchicine有26人(22.6%)最多。改用febuxostat治療前平均血清尿酸 (SUA) 9.5 ± 2.1 mg/dL，治療後6.3 ± 1.8 mg/dL (-3.2, p ＜ 0.001)。Febuxostat 引起副作用肝功能異常有7人(6.1%)、皮疹有3人(2.6%)、噁心有2人(1.7%)。結論：當發現有難控制的高尿酸血症或肝、腎功能異常的痛風病人，febuxostat提供另一降尿酸血症藥物選擇。
並列摘要
Background: Allopurinol has been widely used for the treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase, has been approved by the US Food and Drug Administration for the treatment of hyperuricemia in patients with gout. This study was to explore the efficacy and safety of new drug febuxostat for the treatment of hyperuricemia and gout. Methods: A retrospective study was conducted to search the patients with diagnosis of hyperuricemia or gout (ICD-9-CM -2740: gouty arthritis, 2749: gout) who were treated with febuxostat. We recorded their changes of serum uric acid (SUA) data between April 2013 to March 2014. A SPSS 17.0 for statistical analysis was used. Results: Total 115 patients (74.8% male), the average age of 61.7 ± 17.1 were enrolled. At baseline, the mean SUA was 9.5 ± 2.1 mg/dL; there were 71.2% with kidney disease and hypertension 47% in this study. 27 (23.4%) were treated with allopurinol along and 26 (22.6%) were allopurinol combined with colchicine for their hyperurecmia. After treat with febuxostat, the SUA was significant decreased from 9.5 ± 2.1 mg/dL to 6.3 ± 1.8 mg/dL, p ＜ 0.001. Liver function test abnormalities (6.1%), skin rash (2.6%), and nausea (1.7%) were the most common adverse events. Conclusions: Febuxostat may provide another option for the difficult controlled hyperuricemia, especially with that of liver and kidney dysfunction patients.