Evidence map›Paper›PMID 40883485›Full record

Trial reportJournal of nephrology2025

Comparison of the effect of allopurinol and febuxostat on 2,8-dihydroxyadenine in plasma and urine: a clinical trial.

Hrafnhildur Linnet Runolfsdottir, Unnur Arna Thorsteinsdottir, Steinunn Johannesdottir, Thorunn Oskarsdottir, Inger Maria Schweitz Agustsdottir, Margret Thorsteinsdottir, Runolfur Palsson, Vidar Orn Edvardsson

Abstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in Journal of nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hrafnhildur Linnet RunolfsdottirInternal Medicine Services, Landspitali University Hospital, Reykjavik, Iceland.ORCID http://orcid.org/0000-0003-1826-1383
Unnur Arna ThorsteinsdottirArcticMass, Reykjavik, Iceland.ORCID http://orcid.org/0000-0002-8198-7948
Steinunn JohannesdottirChildren's Medical Center, Landspitali University Hospital, Reykjavik, Iceland.
Thorunn OskarsdottirPharmaceutical Services, Landspitali University Hospital, Reykjavik, Iceland.
Inger Maria Schweitz AgustsdottirChildren's Medical Center, Landspitali University Hospital, Reykjavik, Iceland.
Margret ThorsteinsdottirArcticMass, Reykjavik, Iceland.ORCID http://orcid.org/0000-0002-0649-8503
Runolfur PalssonFaculty of Medicine, University of Iceland, Reykjavik, Iceland. runolfur@landspitali.is.ORCID http://orcid.org/0000-0001-6763-1702
Vidar Orn EdvardssonChildren's Medical Center, Landspitali University Hospital, Reykjavik, Iceland. vidare@landspitali.is.ORCID http://orcid.org/0000-0002-4204-9342

Funding

Icelandic Centre for Research Grant of Excellence 217707-051
6 · The paper itself

Abstract

backgroundAdenine phosphoribosyltransferase (APRT) deficiency is a rare, inherited metabolic disorder characterized by abundant urinary excretion of 2,8-dihydroxyadenine (DHA), causing urinary stones and chronic kidney disease. The aim of this study was to examine the effect of allopurinol and febuxostat on plasma levels and urinary excretion of DHA in individuals with APRT deficiency.

methodsAdult individuals enrolled in the Icelandic APRT Deficiency Registry were invited to participate in a single-center, open-label, crossover, randomized clinical trial comparing the effect of allopurinol 400 mg/day and 800 mg/day and febuxostat 40 mg/day and 80 mg/day on plasma concentration and urinary excretion of DHA.

resultsOf 12 participants who initiated the study, 7 (3 females) completed the trial; median (range) age 57.7 (37.3-65.1) years. Off pharmacotherapy, the median plasma DHA was 300 (178-1315) ng/mL. In individuals taking allopurinol 400 mg/day and 800 mg/day, the median plasma DHA was 25 (below the limit of detection [LOD]-95) ng/mL and below the limit of detection (< LOD-92) ng/mL, respectively. On febuxostat 40 mg/day, the median plasma DHA was below the limit of detection (< LOD-35) ng/mL and on 80 mg/day DHA was below the limit of detection in all samples tested. The median urine DHA-to-creatinine ratio was 8.18 (6.21-18.69) mg/mmol off pharmacotherapy and 1.90 (< LOD-4.52) mg/mmol and 0.35 (< LOD-4.32) mg/mmol on allopurinol 400 mg/day and 800 mg/day, respectively. During treatment with febuxostat 40 mg/day and 80 mg/day, the urine DHA-to-creatinine ratio was 0.54 (< LOD-1.33) mg/mmol and below the limit of detection (< LOD-0.64) mg/mmol, respectively.

conclusionsThe plasma concentration and urinary excretion of DHA decreased markedly on treatment with both study drugs, although febuxostat was more efficacious than allopurinol in both prescribed doses. Trial registration number and date of registration. EudraCT No. 2021-002185-40; https://www.clinicaltrialsregister.eu/ctr-search/search?query=Research+Registry Date on which this record was first entered in the EudraCT database: 2019-03-19.

Indexed as

AdenineAdenine PhosphoribosyltransferaseAllopurinolEnzyme InhibitorsFebuxostatAdultAgedCross-Over StudiesFemaleHumansMaleMetabolism, Inborn ErrorsMiddle AgedTreatment OutcomeUrolithiasis2,8-dihydroxyadenineAdenineAdenine PhosphoribosyltransferaseAllopurinolEnzyme InhibitorsFebuxostatAPRT deficiencyChronic kidney diseasePharmacotherapyUrinary stone diseaseXanthine oxidoreductase inhibitors

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.