Multicenter Randomized Controlled Trial of Intensive Uric Acid Lowering Therapy for CKD Patients with Hyperuricemia: TARGET-UA

Overview

Journal Clin Exp Nephrol

Publisher Springer

Specialty Nephrology

Date 2024 Mar 26

PMID 38530491

Authors

Tetsuya Yamamoto

Masato Kasahara

Kenji Ueshima

Shiro Uemura

Naoki Kashihara

Kenjiro Kimura

Tsuneo Konta

Tetsuo Shoji

Akira Mima

Masashi Mukoyama

Yoshihiko Saito

Affiliations

Soon will be listed here.

Abstract

Background: We investigate whether Intensive uric acid (UA)-lowering therapy (ULT) provides increased renal protection compared with standard therapy in chronic kidney disease (CKD) patients.

Methods: This was a multicenter randomized controlled trial. Only CKD patients with hyperuricemia were included in this study. The participants were randomly assigned to either the Intensive therapy group (target serum UA level ≥ 4.0 mg/dL and < 5.0 mg/dL) or the standard therapy group (serum UA level ≥ 6.0 mg/dL and < 7.0 mg/dL). ULT was performed using topiroxostat, a non-purine-type selective xanthine oxidase inhibitor. The primary endpoint was change in the logarithmic value of urine albumin to the creatinine ratio (ACR) between baseline and week 52 of the treatment.

Results: Three hundred fifty-two patients were included in the full analysis set. In the Standard therapy group, mean serum UA was 8.23 mg/dL at baseline and 6.13 mg/dL at 52 weeks. In the Intensive therapy group, mean serum UA was 8.15 mg/dL at baseline and 5.25 mg/dL at 52 weeks. There was no significant difference in changes in log ACR at 52 weeks between the Intensive therapy and the Standard therapy groups.

Conclusion: This study did not reveal the benefit of Intensive ULT to improve albuminuria levels. (UMIN000026741 and jRCTs051180146).

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