“Febuxostat” lowers uric acid, these three must be clear!

For medical professionals only

Evidence-based medicine, rational drug use

Febuxostat, a 2-arylthiazole derivative, is a xanthine oxidase inhibitor that reduces serum uric acid concentration by inhibiting uric acid synthesis. Compared with allopurinol, febuxostat is a newer uric acid-lowering drug with good uric acid-lowering effect, and has been widely used in clinical practice since its launch [1].

Today, Jie Xiaoyao will tell you what to pay attention to when using febuxostat.

This type of gout patient needs to be careful!

Gout patients with cardiovascular disease treated with febuxostat had higher cardiovascular mortality than allopurinol in a cardiovascular study.

Consider the risks and benefits of febuxostat when deciding to prescribe or continue febuxostat. Febuxostat tablets should only be used in patients with an inadequate response to the maximum dose of allopurinol, in patients with intolerance to allopurinol, or in patients for whom treatment with allopurinol is not recommended [2].

Not recommended for asymptomatic hyperuricemia

For the long-term treatment of hyperuricemia in gout patients. Not recommended for asymptomatic hyperuricemia.

Some patients with hyperuricemia can have no gout attacks for a long time, which is called asymptomatic hyperuricemia. The guidelines for hyperuricemia in Europe and the United States recommend that asymptomatic hyperuricemia should only be treated with uric acid-lowering drugs when combined with chronic kidney disease (CKD) and cardiovascular risk factors [3].

Concomitant use of NSAIDs,

To prevent acute gout attacks

After starting febuxostat, an increase in gout attacks is often observed. This increase is due to a decrease in serum uric acid levels, resulting in the transfer of uric acid from tissue deposits. To prevent gout flares when starting febuxostat, concomitant prophylactic treatment with NSAIDs or colchicine is recommended.

References:

[1] Zhang Shengzhao, Su Na, Xu Jun, et al. Meta-analysis of febuxostat versus allopurinol for cardiovascular adverse events and risk of death in gout patients[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(2):7.

[2]Product Information:FEBUXOSTAT tablet,coated,Alembic Pharmaceuticals Inc.,Updated October 12,2021.

[3]Akkineni R, Tapp S, Tosteson AN, et al.Treatment of asymptomatic hyperuricemia and prevention of vascular disease: a decision analytic approach[J].J Rheumatol,2014,41(4 ):739⁃748.DOI:10.3899/jrheum.121231.

Source: Medicine

Proofreading: Zang Hengjia

Editor in charge: Tian Dongliang

* The medical community strives for the accuracy and reliability of its published content when it is reviewed and approved, but does not regard the timeliness of the published content, and the accuracy and completeness of the cited materials (if any), etc. Make any promises and guarantees, and do not assume any responsibility for the outdated content, possible inaccuracy or incompleteness of the cited information. Relevant parties are requested to check separately when adopting or using it as a basis for decision-making.