DISCUSSION
ASYMPTOMATIC HYPERURICEMIA, OXIDATIVE STRESS
In the current subanalysis, we examined the effect of febuxostat, a selective XO inhibitor, on serum MDA‐LDL level, one of the oxidative stress markers, in patients having asymptomatic hyperuricemia and carotid arterial plaques. Generally, ΔUA was positively correlated with the changes in MDA‐LDL level, but not significantly correlated with the changes in LDL‐C level or MDA‐LDL/LDL‐C ratio. We also demonstrated that febuxostat reduced the MDA‐LDL/LDL‐C ratio compared with that of the controls, and it did not affect the MDA‐LDL or LDL‐C levels. Additionally, the dose of febuxostat did not affect this relationship, although the UA‐lowering effect of febuxostat is dose‐dependent. Patients included in the PRIZE study are frequently encountered in clinical practice, and we believe that long‐term febuxostat treatment for 2 years may decrease the MDA‐LDL/LDL‐C ratio in those patient populations.MDA‐LDL has been recognized as one of the oxidative stress makers and has been implemented in clinical use.Our findings showed that ΔUA was positively related to the change in MDA‐LDL level, displaying the relationship between UA and oxidative stress,Although the antioxidant effect of febuxostat could not be fully elucidated from the present subanalysis, we considered potential reasons why compared with prior studies.We have noted the effect of febuxostat on the reduction in MDA‐LDL/LDL‐C ratio in the present research, and we believe that our results have the following strengths compared with prior reportsThe current subanalysis has several limitations. First, the number of patients in this investigation was originally estimated for an assessment of changes in carotid IMT in the main study