Dotinore may have improved renal function in patients with HUA combined with nephropathy

Although HUA is associated with the progression of CKD, research advances in reducing CKD through uric acid-lowering therapy have been controversial. A study investigated the effect of dortinolide on renal function in patients with severe renal insufficiency by retrospectively analyzing data from 53 outpatients with HUA who were newly treated with dortinolide between December 2020 and October 2022. The results found that serum uric acid levels decreased significantly in all groups.

Although there was no significant change in eGFR in patients in both the 30 ≤ eGFR < 45 mL/min/1.73 m2 and eGFR≥45 mL/min/1.73 m2 groups (P=0.918 and P=0.535), eGFR in patients in the eGFR<30 group was significantly improved (P=0.032), and the proportion of patients with improved eGFR in the eGFR<30 group was significantly higher than that of patients in the 30≤eGFR<45 and eGFR≥45 groups (P=0.038). In multifactorial logistic regression analysis, there was a significant correlation between baseline eGFR<30mL/min/1.73m2, achieving a serum uric acid level of ≤6.0mg/dL, and eGFR improvement (P=0.033 and P=0.015, respectively). The above suggests that dortinore can effectively reduce uric acid levels and has the potential to improve renal function in patients with severe renal insufficiency.

CONCLUSION: The prevalence of HUA is increasing year by year, which not only leads to gout but also increases the risk of CKD. Dotinore, as a highly selective URAT1 inhibitor, has a unique mechanistic advantage in promoting uric acid excretion by blocking renal uric acid reabsorption. Clinical data show that dortinore is effective in lowering uric acid in patients with gout and HUA, and there is no need to adjust the dose in patients with mild to moderate renal insufficiency, which provides a new means for the treatment of patients with gout and renal impairment.