Wednesday, 15 Aug 2018

You are here

Febuxostat (IR or XR) Effective in Gout with Renal Impairment

Saag and colleagues report the results of a 3 month phase III trial demonstrating equal efficacy between febuxostat extended release (XR) and immediate release (IR) formulations in patients with gout.  and normal or impaired renal function.

This multicenter, placebo-controlled, double-blind study enrolled 1790 gout patients with normal or impaired (mild to severe) renal function and randomized them to receive placebo, febuxostat IR 40 or 80 mg, or febuxostat XR 40 or 80 mg once daily (1:1:1:1:1 ratio).

Febuxostat in either formulation was significantly better at achieving sUA <5.0 mg/dL or sUA <6.0 mg/dL at Month 3 (P<0.001 versus placebo).

While both febuxostat XR and IR had similar effects on sUA endpoints, significantly more patients achieved sUA <5.0 mg/dL with XR 40 mg versus IR 40 mg.

Flare rates were similar across all treatment groups and no new or extraordinary safety concerns were raised by these studies. Adverse events were low in frequency and lead by  diarrhea, nasopharyngitis, and hypertension.

Both febuxostat formulations were well tolerated and equally effective (sUA) in patients with normal and impaired renal function. These data do add to the growing body of evidence supporting the use of febuxostat in the management of hyperuricemia in patients with renal impairment.  

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Selective Use of HLA-B*5801 Testing in Gout

The current edition of JAMA Internal Medicine describes an Asian gout patient who presents with an allopurinol hypersensitivity reaction that could have been diagnosed by testing for HLA-B*5801.

Steroids vs. NSAIDs in Treating Acute Gout

Gout, the ancient disease of kings is usually treated with the ancient (and costly) drug colchicine, often without consideration of nonsteroidal antiinflammatory drugs (NSAID) or corticosteroids. A recent metanalysis compared the NSAIDS and steroids and showed that both were equipotent in managing the pain of acute gout, but corticosteroids appear had a more favorable safety profile. 

Erectile Dysfunction in Gout

The Journal of Rheumatology reports a population-based study demonstrating that gout is associated with an increased risk of developing erectile dysfunction (ED) suggesting that hyperuricemia and inflammation may be independent risk factors for ED.

Immunophysiology of the Gout Attack

Gout may be an ancient disease, with arthritis of the big toe having been described in Egypt in 2,600 BC, but only now are the underlying pathophysiologic events being elucidated and understood.

Obesity, Hypertension and Diuretics Drive Gout Risk

A recent metanalysis suggests that obesity, hypertension and diuretic use are associated with a two-fold increased risk of incident gout.

From a potential of 9923 articles, researchers analyzed 11 studies with data suitable for the meta-analysis.

Gout was 2.24 times more likely to occur in individuals with body mass index ≥ 30 kg/m2 (adjusted relative risk 2.24 (95% confidence interval) 1.76–2.86).