Analysis on rationality of antihyperuricemic drugs application and detection of HLA-B*5801 alleles in patients with chronic kidney diseases complicated by hyperuricemia
10.3760/cma.j.issn.1008-5734.2019.01.004
- VernacularTitle:慢性肾脏病合并高尿酸血症患者降尿酸药物应用和HLA-B*5801等位基因检测合理性分析
- Author:
Di ZHANG
1
;
Siying CHEN
;
Zhihua YANG
;
Wanhong LU
;
Yalin DONG
Author Information
1. 西安交通大学第一附属医院药学部 710061
- Publication Type:Journal Article
- Keywords:
Hyperuricemia;
Alleles;
Benzbromarone;
Allopurinol;
Febuxostat
- From:
Adverse Drug Reactions Journal
2019;21(1):15-19
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the rationality of antihyperuricemic drugs application and HLA-B*5801 alleles detection in patients with chronic kidney diseases complicated by hyperuricemia. Methods The medical records of patients with chronic kidney diseases complicated by hyperuricemia in the First Affiliated Hospital of Xi′an Jiaotong University from July 2015 to June 2017,whose HLA-B*5801 alleles were detected and who were treated with benzbromarone,allopurinol,or febuxostat,were collected and analyzed retrospectively. The evaluation criteria of rationality of 3 antihyperuricemic drugs application and gene detection were constituted according to the related guidelines,expert consensuses,and drug labels. It was judged as irrational use of benzbromarone in patients with estimating glomerular filtration rate (eGFR)< 30 ml/(min · 1. 73 m2 ),excessive uric acid production,acute gout attack,urinary calculi,or undetermined uric acid excretion type. It was judged as irrational use of allopurinol in patients whose eGFR were < 15 ml/(min·1. 73 m2 )but without dialysis or in patients with positive HLA-B*5801 alleles. It was judged as irrational use of gene detection in patients who had underwent gene detection but were not suitable for allopurinol treatment after initial assessment,and in patients who finally were not given allopurinol though they were suitable for allopurinol treatment after initial assessment and with negative HLA-B*5801 alleles. Results A total of 201 patients enrolled in the study. There were 57,103,and 41 patients receiving benzbromarone,allopurinol,and febuxostat,respectively. There were 24 (11. 9％)patients with positive HLA-B*5801 alleles and 177 (88. 1％)with negative one. The percentages of patients with rational use of benzbromarone,allopurinol,and febuxostat were 40. 4％ (23/ 57),76. 7％ (79/ 103)and 100％ (41/ 41), respectively. The percentage of patients with rational use of HLA-B*5801 alleles detection was 50. 2％(101 / 201). There were 100 patients with irrational use of HLA-B*5801 alleles detection,including 34 patients who underwent gene detection but were not suitable for allopurinol treatment [their eGFRs were <15 ml/(min·1. 73 m2 )but they did not conduct dialysis],and 66 patients who were not given allopurinol despite that they were suitable for allopurinol treatment with negative HLA-B*5801 alleles. Conclusions There are irrational use of both antihyperuricemic drugs and HLA-B*5801 alleles detection in patients with chronic kidney diseases complicated by hyperuricemia in our hospital. Irrational use of benzbromarone is more serious in antihyperuricemic drugs. Clinicians should pay attention to the irrational use of antihyperuricemic drugs.
