Febuxostat treatment for gout: what the clinician needs to know

Abstract

Febuxostat is a new non-purine based inhibitor of xanthine oxidase that will be a useful addition to the drugs available to treat gout. This short review covers general principles of the management of gout and then focuses on practical aspects and use of febuxostat.

Keywords

febuxostat allopurinol colchicine probenecid gout

References

Becker, M.A. , Schumacher Jr, H.R. , Wortmann, R.L. , MacDonald, P.A. , Eustace, D. , Palo, W.A. et al. (2005) Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 353: 2450-2461.

Borstad, G.C. , Bryant, L.R. , Abel, M.P. , Scroggie, D.A. , Harris, M.D. and Alloway, J.A. ( 2004) Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis. J Rheumatol 31: 2429-2432.

Chen, L.X. and Schumacher, H.R. ( 2008) Gout: an evidence-based review. J Clin Rheumatol 14: S55-S62.

Dalbeth, N. , Collis, J. , Gregory, K. , Clark, B. , Robinson, E. and McQueen, F.M. ( 2007) Tophaceous joint disease strongly predicts hand function in patients with gout. Rheumatology (Oxford) 46: 1804-1807. Epub 2007 Nov 3.

Dalbeth, N. , Kumar, S. , Stamp, L. and Gow, P. ( 2006) Dose adjustment of allopurinol according to creatinine clearance does not provide adequate control of hyperuricemia in patients with gout. J Rheumatol 33: 1646-1650.

Hande, K.R. , Noone, R.M. and Stone, W.J. ( 1984) Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am J Med 76: 47-56.

Lawrence, R.C. , Felson, D.T. , Helmick, C.G. , Arnold, L.M. , Choi, H. , Deyo, R.A. et al. (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 58: 26-35.

Loeb, J.N. ( 1972) The influence of temperature on the solubility of monosodium urate. Arthritis Rheum 15: 189-192.

Malik, A. , Schumacher, H.R. , Dinnella, J.E. and Clayburne, G.M. (2009) Clinical diagnostic criteria for gout. Comparison with the gold standard of synovial fluid crystal analysis. J Clin Rheumatol 15: 22-24.

10.

Mikuls, T.R. , Farrar, J.T. , Bilker, W.B. , Fernandes, S. , Schumacher Jr, H.R. and Saag, K.G. ( 2005) Gout epidemiology: results from the UK General Practice Research Database, 1990-1999. Ann Rheum Dis 64: 267-272.

11.

Mikuls, T.R. , MacLean, C.H. , Olivieri, J. , Patino, F. , Allison, J.J. , Farrar, J.T. et al. (2004) Quality of care indicators for gout management . Arthritis Rheum 50: 937-943.

12.

Neogi, T. , Hunter, D.J. , Chaisson, C.E. , Allensworth-Davies, D. and Zhang, Y. ( 2006) Frequency and predictors of inappropriate management of recurrent gout attacks in a longitudinal study. J Rheumatol 33: 104-9. Epub 2005 Nov 1.

13.

Reinders, M.K. , Haagsma, C. , Jansen, T.L. , van Roon, E.N. , Delsing, J. , van de Laar, M.A. et al. (2009) A randomised controlled trial on the efficacy and tolerability with dose escalation of allopurinol 300-600 mg/day versus benzbromarone 100-200 mg/day in patients with gout. Ann Rheum Dis 68: 892-897. Epub 2008 Jul 16.

14.

Roddy, E. , Zhang, W. and Doherty, M. ( 2007) Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations. Ann Rheum Dis 66: 1311-5. Epub 2007 May 15.

15.

Sarawate, C.A. , Patel, P.A. , Schumacher, H.R. , Yang, W. , Brewer, K.K. and Bakst, A.W. ( 2006) Serum urate levels and gout flares: analysis from managed care data. J Clin Rheumatol 12: 61-65.

16.

Schumacher, H.R. , Becker, M.A. , Lloyd, E. , MacDonald, P.A. and Lademacher, C. (2009) Febuxostat in the treatment of gout: 5-year findings of the FOCUS efficacy and safety study. Rheumatology (Oxford) 48: 188-194.

17.

Schumacher, H.R. , Becker, M.A. , Wortmann, R.L. , MacDonald, P.A. , Hunt, B. , Street, J. et al. (2008) Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III randomized, double-blind, parallel-group trial. Arthritis Rheum 59: 1540-1548.

18.

Singh, J.A. and Strand, V. ( 2008) Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans. Ann Rheum Dis 67: 1310-1316. Epub 2008 Jan 4.

19.

Sundy, J.S. , Becker, M.A. , Baraf, H.S.B. , Barkhuizen, A. , Moreland, L.W. , Huang, W. et al. (2008) Reduction of plasma urate levels following treatment with multiple dose of pegloticase (Polyethylene glycol-conjugated uricase) in patients with treatment-failure Gout. Results of a phase II randomized study. Arthritis Rheum 58: 2882-2891.

20.

US Food and Drug Administration Center for Drug Evaluation and Research Website http://www.accessdata.fda.gov/Scripts/cder/DrugsSatFDA/ , accessed March 4, 2009.

21.

Vázquez-Mellado, J. , García, C.G. , Vázquez, S.G. , Medrano, G. , Ornelas, M. , Alcocer, L. et al. (2004) Metabolic Syndrome and Ischemic Heart Disease in Gout. J Clin Rheumatol 10: 105-109.

22.

Vázquez-Mellado, J. , Morales, E.M. , Pacheco-Tena, C. and Burgos-Vargas, R. ( 2001) Relation between adverse events associated with allopurinol and renal function in patients with gout. Ann Rheum Dis 60: 981-983.

23.

Zhang, W. , Doherty, M. , Bardin, T. , Pascual, E. , Barskova, V. , Conaghan, P. et al. (2006) EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 65: 1312-1324. Epub 2006 May 17.