Navigating the choice between topiroxostat and febuxostat for hyperuricemia management: A prospective comparative study

Abstract

Hyperuricemia is a metabolic condition associated with various health complications, including gout, kidney disease, and cardiovascular events. Topiroxostat and febuxostat are two commonly prescribed xanthine oxidase inhibitors for managing hyperuricemia, yet there is a paucity of direct comparative studies evaluating their efficacy and safety profiles. To address this gap, we conducted a prospective, randomized, open-label, parallel-group trial involving 50 patients diagnosed with hyperuricemia. Patients were randomly assigned to receive either topiroxostat or febuxostat for a duration of 12 weeks. Primary outcome measures included changes in serum uric acid (SUA) levels, while secondary outcomes encompassed renal function parameters and incidence of adverse events. Our findings indicate that both topiroxostat and febuxostat effectively reduced SUA levels over the treatment period, with no significant difference observed between the two groups. However, topiroxostat demonstrated a more significant reduction in serum creatinine levels, urinary albumin excretion, and improvement in estimated glomerular filtration rate (eGFR) compared to febuxostat. Safety profiles were favorable for both medications, with no serious adverse events reported. These results suggest that while both topiroxostat and febuxostat are effective in lowering SUA levels, topiroxostat may offer additional renal protective benefits. Further comparative studies are warranted to elucidate the clinical implications and optimal use of these medications in hyperuricemia management.