Abstract P401: The Difference in Improvement of Kidney Function Between Febuxostat and Topiroxostat in Hypertensive Patients

Introduction: Control of uric acid level (UA) plays an important role in the protection of organs in patients with hypertension (HTN). Newly developed xanthine oxidase inhibitors, febuxostat (FBX) and topiroxostat (TPX) are expected to lead to more reduction of organ damages. However, the effects of them in a clinical situation remain unclear. We hypothesized these drugs have different effects based on the difference in action mechanism. Objective: To reveal the effects of FBX and TPX on clinical parameters and compare them between the drugs. Method: We retrospectively collected stable HTN patients with hyperuricemia (HU) who newly received a prescription of FBX or TPX and continued at least 12 weeks. Those who had other uric acid-lowering drugs or severe proteinuria were excluded. Participants were divided into FBX and TPX groups matched for age and sex. Result: The almost baseline characteristics were not significantly different between both groups except the usage of renin-angiotensin inhibitors (Table). Administration of FBX or TPX lowered UA significantly (p<0.0001). Contrary to previous reports, blood pressure and urinary albumin-to-creatinine ratio were not significantly changed between both groups. However, eGFR in only TPX group was significantly increased from 57.2 ±15.0 to 60.6 ±15.7 mL/min/1.73m 2 (p=0.006), while FBX group was not. In TPX group, there was no significant difference in change of eGFR between patients using high and low amount of TPX. Conclusion: Our current study revealed TPX, not FBX, could improve eGFR in HTN patients. Moreover, the effect seemed to be independent of the amount of TPX. TPX could be 1st-line choice in HTN patients with HU.