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Girigoswami K, Arunkumar R, Girigoswami A. Management of hypertension addressing hyperuricaemia: introduction of nano-based approaches. Ann Med 2024; 56:2352022. [PMID: 38753584 PMCID: PMC11100442 DOI: 10.1080/07853890.2024.2352022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Uric acid (UA) levels in blood serum have been associated with hypertension, indicating a potential causal relationship between high serum UA levels and the progression of hypertension. Therefore, the reduction of serum UA level is considered a potential strategy for lowering and mitigating blood pressure. If an individual is at risk of developing or already manifesting elevated blood pressure, this intervention could be an integral part of a comprehensive treatment plan. By addressing hyperuricaemia, practitioners may subsidize the optimization of blood pressure regulation, which illustrates the importance of addressing UA levels as a valuable strategy within the broader context of hypertension management. In this analysis, we outlined the operational principles of effective xanthine oxidase inhibitors for the treatment of hyperuricaemia and hypertension, along with an exploration of the contribution of nanotechnology to this field.
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Affiliation(s)
- Koyeli Girigoswami
- Medical Bionanotechnology, Faculty of Allied Health Sciences, Chettinad Hospital & Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, India
| | - Radhakrishnan Arunkumar
- Department of Pharmacology, Chettinad Hospital & Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, India
| | - Agnishwar Girigoswami
- Medical Bionanotechnology, Faculty of Allied Health Sciences, Chettinad Hospital & Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, India
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Chen W, Jiang B, Ruan Z, Yang D, Hu Y, Lou H. Population pharmacokinetic analysis of febuxostat with high focus on absorption kinetics and food effect. BMC Pharmacol Toxicol 2024; 25:57. [PMID: 39187897 PMCID: PMC11348603 DOI: 10.1186/s40360-024-00783-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 08/14/2024] [Indexed: 08/28/2024] Open
Abstract
Febuxostat is commonly used in clinic for the treatment of hyperuricemia. Multiple-peak phenomenon has been observed in human plasma concentration-time profiles of febuxostat, but has not been paid enough attention in previous research. This study takes a pivotal step forward by conducting a comprehensive population pharmacokinetic (PopPK) analysis of febuxostat in a healthy Chinese cohort, with a central focus on delineating its absorption profile under contrasting fasting and fed conditions, while concurrently assessing the influence of food alongside other potential covariates on febuxostat's PK profile. The plasma concentration data used for modeling was obtained from two bioequivalence (BE) studies. Subjects were administered febuxostat 20 mg or 80 mg under fasting or fed condition. Goodness-of-fit plots, visual predict check (VPC), and normalized prediction distribution error (NPDE) were used for model evaluation. Based on the established model, PK profiles in healthy Caucasian subjects were simulated with parameter adjustment for race difference on clearance and bioavailability. Data from 128 subjects were used in the PopPK analysis. Febuxostat concentration-time curves were described by a two-compartment model with two deposit absorption compartments and lag times (Tlag). Prandial states (Food) showed significant impact on absorption rate ka1 and ka2, as well as Tlag1, and body weight was identified as a significant covariate on the apparent distribution volume. The PopPK analysis of febuxostat in healthy Chinese volunteers, under both fasted and fed conditions, successfully characterized its PK profile and underscored the significant influence of food on absorption. The potential difference of absorption between Chinese population and Caucasian population indicated from the simulations needs further investigation.
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Affiliation(s)
- Wenjun Chen
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Bo Jiang
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zourong Ruan
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dandan Yang
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yin Hu
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Honggang Lou
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Sarhan II, Abdellatif YA, Saad RE, Teama NM. Renoprotective effect of febuxostat on contrast-induced acute kidney injury in chronic kidney disease patients stage 3: randomized controlled trial. BMC Nephrol 2023; 24:65. [PMID: 36949408 PMCID: PMC10035112 DOI: 10.1186/s12882-023-03114-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Contrast-induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, it is associated with adverse outcomes such as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in the prevention of contrast-induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI). METHODS In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6-18 h before and within 6-18 h after the coronary intervention (a time gap of 24 h between two doses). Group II (control group): included 60 patients who received only traditional treatment. RESULTS The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk. CONCLUSION We demonstrated that febuxostat has a Reno protective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI.
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Affiliation(s)
- Iman Ibrahim Sarhan
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt
| | - Yasser A Abdellatif
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Nahla Mohamed Teama
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt.
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Kamel B, Abuhelwa AY, Foster D, Duong JK, Graham GG, Williams KM, Pile KD, Day RO. Population pharmacokinetic modelling of febuxostat in healthy subjects and people with gout. Br J Clin Pharmacol 2022; 88:5359-5368. [PMID: 35849446 PMCID: PMC9796681 DOI: 10.1111/bcp.15462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 01/07/2023] Open
Abstract
AIMS To investigate and characterise the pharmacokinetics of febuxostat and the effect of the covariates of renal function and body size descriptors on the pharmacokinetics of the drug. METHODS Blood samples (n = 239) were collected using sparse and rich sampling strategies from healthy (n = 9) and gouty (n = 29) subjects. Febuxostat plasma concentrations were measured by a validated high-performance liquid chromatography method. Population pharmacokinetic analysis was performed using NONMEM. A common variability on bioavailability (FVAR) approach was used to test the effect of fed status on absorption parameters. Covariates were modelled using a power model. RESULTS The time course of the plasma concentrations of febuxostat is best described by a two-compartment model. In the final model, the population mean for apparent clearance (CL/F), apparent central volume of distribution (Vc/F), apparent peripheral volume of distribution (Vp/F), absorption rate constant (ka) and apparent intercompartmental clearance (Q/F) were 6.91 l h-1 , 32.8 l, 19.4 l, 3.6 h-1 and 1.25 l h-1 , respectively. The population parmater variability (coefficient of variation) for CL/F, Vc/F and Vp/F were 13.6, 22 and 19.5%, respectively. Food reduced the relative biovailability and ka by 67% and 87%, respectively. Renal function, as assessed by creatinine clearance, was a significant covariate for CL/F while body mass index was a significant covariate for Vc/F. CONCLUSIONS Renal function and body mass index were significant covariates. Further work is warranted to investigate the clinical relevance of these results, notably as renal impairment and obesity are common occurrences in people with gout.
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Affiliation(s)
- Bishoy Kamel
- The George Institute for Global HealthSydneyNew South WalesAustralia,St Vincent's Clinical SchoolUniversity of New South Wales SydneyNew South WalesAustralia,Department of Clinical Pharmacology and ToxicologySt Vincent's Hospital and University of New South Wales SydneyNew South WalesAustralia,School of Medical SciencesUniversity of New South Wales SydneyNew South WalesAustralia
| | - Ahmad Y. Abuhelwa
- College of PharmacyUniversity of SharjahSharjahUnited Arab Emirates,College of Medicine and Public HealthFlinders UniversitySouth AustraliaAustralia,Australian Centre for Precision Health, Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAustralia
| | - David Foster
- Australian Centre for Precision Health, Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAustralia
| | - Janna K. Duong
- Faculty of PharmacyThe University of SydneySydneyNew South WalesAustralia
| | - Garry G. Graham
- Department of Clinical Pharmacology and ToxicologySt Vincent's Hospital and University of New South Wales SydneyNew South WalesAustralia,School of Medical SciencesUniversity of New South Wales SydneyNew South WalesAustralia
| | - Kenneth M. Williams
- Department of Clinical Pharmacology and ToxicologySt Vincent's Hospital and University of New South Wales SydneyNew South WalesAustralia,School of Medical SciencesUniversity of New South Wales SydneyNew South WalesAustralia
| | - Kevin D. Pile
- Department of MedicineWestern Sydney UniversityNew South WalesAustralia,Department of Rheumatology, Campbelltown HospitalSydneyNew South WalesAustralia
| | - Richard O. Day
- St Vincent's Clinical SchoolUniversity of New South Wales SydneyNew South WalesAustralia,Department of Clinical Pharmacology and ToxicologySt Vincent's Hospital and University of New South Wales SydneyNew South WalesAustralia
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Honorary Professor Garry Graham. Inflammopharmacology 2021; 29:1255-1259. [PMID: 34533655 DOI: 10.1007/s10787-021-00872-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
An appreciation of the contribution of Professor Gary Graham to anti-inflammatory and antirheumatic pharmacology and clinical pharmacology.
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Kamel B, Graham GG, Stocker SL, Liu Z, Williams KM, Carland JE, Pile KD, Day RO. A pharmacokinetic-pharmacodynamic study of a single dose of febuxostat in healthy subjects. Br J Clin Pharmacol 2020; 86:2486-2496. [PMID: 32386239 DOI: 10.1111/bcp.14357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 01/03/2023] Open
Abstract
AIMS To examine the pharmacokinetic-phamacodynamic (PK-PD) relationships of plasma febuxostat and serum urate and the effect of a single dose of the drug on renal excretion and fractional clearance of urate (FCU). METHODS Blood and urine samples were collected at baseline and up to 145 hours following administration of febuxostat (80 mg) to healthy subjects (n = 9). Plasma febuxostat and serum and urinary urate and creatinine concentrations were determined. Febuxostat pharmacokinetics were estimated using a two-compartment model with first-order absorption. An Emax PK-PD model was fitted to mean febuxostat and urate concentrations. Urinary urate excretion and FCU were calculated pre- and post-dose. RESULTS Maximum mean plasma concentration of febuxostat (2.7 mg L-1 ) was observed 1.2 hours after dosage. Febuxostat initial and terminal half-lives were 2.0 ± 1.0 and 14.0 ± 4.7 hours (mean ± SD), respectively. The majority (81%) of the drug was eliminated in the 9 hours after dosing. Serum urate declined slowly achieving mean nadir (0.20 mmol L-1 ) at 24 hours. The IC50 (plasma febuxostat concentration that inhibits urate production by 50%) was 0.11 ± 0.09 mg L-1 (mean ± SD). Urinary urate excretion changed in parallel with serum urate. There was no systematic or significant change in FCU from baseline. CONCLUSION The PK-PD model could potentially be used to individualise febuxostat treatment and improve clinical outcomes. A single dose of febuxostat does not affect the efficiency of the kidney to excrete urate. Further investigations are required to confirm the present results following multiple dosing with febuxostat.
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Affiliation(s)
- Bishoy Kamel
- The George Institute for Global Health, Australia.,St Vincent's Clinical School, University of New South Wales, Australia.,Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Australia
| | - Garry G Graham
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Australia
| | - Sophie L Stocker
- St Vincent's Clinical School, University of New South Wales, Australia.,Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Zhixin Liu
- Stats Central, University of New South Wales, Kensington, NSW, Australia
| | - Kenneth M Williams
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Australia
| | - Jane E Carland
- St Vincent's Clinical School, University of New South Wales, Australia.,Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Kevin D Pile
- Department of Medicine, Western Sydney University, New South Wales, Australia.,Department of Rheumatology, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - Richard O Day
- St Vincent's Clinical School, University of New South Wales, Australia.,Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
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