Ps-c34-7: effect of febuxostat on the level of malondialdehyde-modified low-density lipoprotein, as an oxidant marker, from the sub-analyses of prize study

Background: Febuxostat is a selective xanthine oxidase inhibitor that has been reported to possess antioxidant properties in experimental and animal studies. We previously conducted the program of vascular evaluation under uric acid control by xanthine oxidase inhibitor, febuxostat: multicenter, randomized controlled (PRIZE) study to evaluate the progression of carotid lesions in asymptomatic hyperuricemic patients with carotid atherosclerosis treated with febuxostat for 2 years compared with a control group. In the present sub-analysis study of the PRIZE study, the effect of febuxostat on the level of malondialdehyde modified low density lipoprotein (MDA-LDL), one of the oxidative stress markers, was examined. Methods: The subjects were 381 patients enrolled in the PRIZE trial for whom MDA-LDL measurements were available at baseline and at 24 months (182 in the febuxostat group and 199 in the control group). Uric acid (UA) levels, MDA-LDL levels, and MDA-LDL/LDL-C were determined, expressed as the estimated difference from baseline to 24 months, and compared between the two groups. We also examined the relationship between febuxostat dose (10 mg, 20–40 mg, 40–60 mg) and changes in MDA-LDL or MDA-LDL/LDL-C. Results: Febuxostat significantly reduced the level of UA, compared with that in the control group, in a dose-dependent manner (p < 0.001). The estimated difference in MDA-LDL/LDL-C from baseline to 24 months was significantly lower in the Febuxostat group than that in the control group (p = 0.025), while the estimated difference in MDA-LDL from baseline to 24 months was not different in the two groups (p = 0.235). There was no significant correlation between the dose of febuxostat and the estimated difference in MDA-L/LDL-C (p = 0.626). Conclusions: In asymptomatic hypereuricemia patients with carotid atherosclerosis, febuxostat may have some antioxidant effect, but the effect may not be dose-dependent.