Transplant Trial Watch

Efficacy and safety of febuxostat for treatment of asymptomatic hyperuricemia among kidney transplant patients: A meta-analysis of observational studies.

Chewcharat, A., et al.

Clinical Transplantation 2020; 34(4): e13820.

This study aimed to investigate the safety and efficacy of febuxostat for treating asymptomatic hyperuricemia among renal transplant recipients.

A literature search was conducted on Embase, PubMed, and Cochrane Central Register of Controlled Trials. Studies were assessed for eligibility by two independent reviewers. The risk of bias was evaluated using the Newcastle-Ottawa scale.

7 studies were included in the review.

Serum uric acid (UA), serum UA change rate per year, estimated glomerular filtration rate (eGFR), eGFR change rate, number of patients who achieved target of serum UA < 6 mg/dL within a year, tacrolimus trough level, hemoglobin (Hb), white blood cell counts (WBC), aspartate aminotransferase (AST), and alanine aminotransferase (ALT).


CET Conclusions
The aim of the systematic review and meta-analysis was to evaluate the efficacy and safety of febuxostat in kidney transplant recipients. The bibliographic search of three databases identified only 33 observational studies suggesting that the search was insufficient and may have missed relevant studies. Seven studies (n=367 patients) met the inclusion criteria. Study identification was completed by two independent reviewers but there was no description whether data extraction and methodological quality assessment were conducted by independent reviewers. Random effect models were used to pool data across studies. Meta-analysis of seven studies showed that febuxostat significantly lowered serum UA but the analysis had high heterogeneity, which the authors did not attempt to explain. There were no differences between groups for any of the safety outcomes, including haemoglobin, white blood cell counts, liver enzymes including aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

Trial registration
PROSPERO - CRD42019143079

Funding source
Not reported