Changes in Uric Acid Levels and Effects on Renal Function After Switching From Febuxostat to Dotinurad in Patients With Chronic Kidney Disease: A Retrospective Study

Dotinurad is a novel and selective uric acid (UA) reabsorption inhibitor. On the other hand, febuxostat, a xanthine oxidase inhibitor, reduces UA production, but its UA-lowering effect is limited. Therefore, this study will compare UA levels to baseline values after switching from febuxostat to dotinurad in hyperuricemic patients with chronic kidney disease (CKD), and will evaluate the effects on renal function and safety. Eight eligible patients with CKD who had been treated with febuxostat (10-20 mg/day) for more than six months and then switched to dotinurad (0.5-4 mg/day) were studied retrospectively. Changes in UA levels, the percentage of patients achieving a UA level below 6.0 mg/dL, and changes in estimated glomerular filtration rate (eGFR) were analyzed. Serum UA did not change significantly with the switch from febuxostat to dotinurad, but the rate of UA levels below 6.0 mg/dL was maintained or achieved in 63% of cases. The eGFR slope tended to slow with the change to dotinurad, but the difference was not statistically significant. Furthermore, no severe side effects were observed in any of the patients during the observation period. In CKD patients with hyperuricemia, the change from febuxostat to dotinurad did not cause a significant change in UA levels. The eGFR slope tended to slow with the change to dotinurad, although the difference was not statistically significant.