Chronic hyperglycemia may attenuate the serum-uric-acid-lowering effect of low-dose febuxostat in Japanese patients with type 2 diabetes mellitus.

Aims: This study investigated the independent predictors of the serum uric acid (sUA)-lowering effect of low-dose febuxostat, a novel xanthine oxidase inhibitor, in Japanese patients with type 2 diabetes mellitus (T2DM).

Materials And Methods: Data of 130 T2DM patients who had been taking febuxostat 10 mg once daily for elevated sUA (≥7 mg/dl) for at least 12 weeks were retrieved from medical records. Spearman's rank correlation coefficients were calculated to determine the correlations between sets of two independent continuous variables. Multiple stepwise linear regression analysis was used to determine independent predictors of the percent change of sUA levels after 12 weeks of febuxostat treatment (%ΔsUA).

Results: Among all patients, %ΔsUA was significantly correlated with age ( = 0.192,  = 0.030) and mean glycated hemoglobin (HbA) level ( = -0.186,  = 0.036). Multiple stepwise linear regression analysis of all patients revealed that major independent factors contributing to %ΔsUA were mean HbA (β = -3.14,  = 0.022) and mean glycated albumin (β = -0.743,  = 0.013) levels.

Conclusions: High HbA and glycated albumin levels significantly attenuated the sUA-lowering effect of low-dose febuxostat in Japanese patients with T2DM. Further detailed analysis using a larger population is warranted to confirm these findings.