Febuxostat Compared with Allopurinol in Patients with Hyperuricemia and Gout

• Published in: The New England journal of medicine Vol. 353; no. 23; pp. 2450 - 2461
• Main Authors: Becker, Michael A, Schumacher, H. Ralph, Wortmann, Robert L, MacDonald, Patricia A, Eustace, Denise, Palo, William A, Streit, Janet, Joseph-Ridge, Nancy
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 08.12.2005
• Subjects: Allopurinol - adverse effects; Allopurinol - therapeutic use; Biological and medical sciences; Double-Blind Method; Enzyme Inhibitors - therapeutic use; Febuxostat; Female; General aspects; Gout - complications; Gout - drug therapy; Gout - pathology; Gout Suppressants - adverse effects; Gout Suppressants - therapeutic use; Health Insurance Portability & Accountability Act 1996-US; Humans; Hyperuricemia - complications; Hyperuricemia - drug therapy; Male; Medical sciences; Metabolic diseases; Middle Aged; Other metabolic disorders; Purines and pyrimidines (gout, hyperuricemia...); Rodents; Thiazoles - adverse effects; Thiazoles - therapeutic use; Uric Acid - blood; Urine; Xanthine Oxidase - antagonists & inhibitors; Human; Hypouricemic agent; Enzyme; Febuxostat; Allopurinol; Gout; Diseases of the osteoarticular system; Enzyme inhibitor; Xanthine dehydrogenase; Metabolic diseases; Patient; Uric acid; Medicine; Hyperuricemia; Xanthine oxidase; Purine; Oxidoreductases; Microcrystal; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa050373

In this randomized trial of patients with elevated uric acid levels and gout, febuxostat, a new nonpurine selective inhibitor of xanthine oxidase, was compared with allopurinol. The incidence of gout flares was similar in patients treated with allopurinol and febuxostat. Both doses of febuxostat (80 and 120 mg) were more effective than 300 mg of allopurinol in lowering uric acid levels. In patients with elevated uric acid levels and gout, febuxostat was compared with allopurinol. The incidence of gout flares was similar, but febuxostat was more effective than allopurinol in lowering uric acid levels. Hyperuricemia, defined as a serum urate concentration exceeding the limit of solubility (about 6.8 mg per deciliter [400 μmol per liter]), is a common biochemical abnormality that reflects supersaturation of the extracellular fluid with urate and predisposes affected persons to gout. The clinical manifestations of gout (acute gouty arthritis, gouty arthropathy, chronic tophaceous gout, uric acid urolithiasis, and gouty nephropathy) result from deposition of monosodium urate or uric acid crystals from supersaturated body fluids. 1 The solubility of monosodium urate in extracellular fluids is influenced by a variety of factors, including pH, temperature, and sodium ion and protein concentrations 2 – 9 ; . . .