In addition, the pharmacokinetics see more of neither selleck chemical unchanged topiroxostat nor of its metabolites is affected by mild-to-moderate renal impairment (unpublished data). In the treatment of hyperuricemia and gout,

XO inhibitors such as allopurinol or febuxostat are considered to be first-line drugs [15]. However, in a view of safety concern, the reduction of allopurinol dose is recommended in patients with renal impairment; furthermore, the urate-lowering efficacy of allopurinol is inadequate to control hyperuricemia in patients with gout [16–19]. On the other side, febuxostat has been shown to exhibit urate-lowering efficacy in patients with renal impairment [20]. However, the usage experience of febuxostat in CKD patients is still insufficient [21]. The objective of this multicenter, double-blind, randomized placebo-controlled study was to evaluate the effect of topiroxostat in reducing the serum urate level, and to improve the estimated glomerular filtration rate learn more (eGFR), urinary albumin-to-creatinine ratio (ACR), blood pressure, and serum adiponectin levels

in hyperuricemic patients with renal impairment, with or without gout. Methods The protocol and informed consent form were reviewed and approved by the institutional review board at each study center. This study was conducted in compliance with the Declaration of Helsinki (1996 version), Good Clinical Practice guidelines and other applicable regulatory requirements. Written informed consent was obtained from all trial subjects before conducting of any study-specific procedures. The information of this study was registered to the Japan Pharmaceutical Information Center (JAPIC) on June 28, 2010 (Registration Number: JapicCTI-101171). Study design, study population and treatment This study was a 22-week, multicenter, randomized, double-blind, placebo-controlled Telomerase study carried out in Japan to assess the efficacy and tolerability of topiroxostat in hyperuricemic patients with renal impairment, with or without gout. Eligible patients

were men or women aged 20–75 years, with hyperuricemia (defined as serum urate levels >475.84 μmol/L, or serum urate levels >416.36 μmol/L in patients with gout), and eGFR of ≥30 to <60 mL/min/1.72 m2 within the preceding 3 months. The exclusion criteria were: onset of gouty arthritis within 2 weeks prior to the start of the study (baseline); nephrotic syndrome; renal function impairment associated with nephrolithiasis or urolithiasis; change of the serum creatinine level by more than 44.2 μmol/L per month within the 8-week run-in period; hyperuricemia possibly secondary to a malignant tumor or other diseases; HbA1c ≥8.0 %; severe hypertension (SBP ≥180 mmHg or DBP ≥110 mmHg); hepatic dysfunction (AST or ALT ≥100 IU/L); cancer; pregnancy; breastfeeding; serious hepatic disease; serious heart disease; any other significant medical conditions.