NEW YORK (Reuters Health) Nov 28 - The xanthine oxidase inhibitor, febuxostat, lowers serum urate levels to a greater extent than allopurinol in patients with gout, researchers report in the November 15 issue of Arthritis & Rheumatism.
Dr. H. Ralph Schumacher, Jr., of the University of Pennsylvania and VA Medical Center in Philadelphia and colleagues randomized 1072 patients with gout to febuxostat 80 mg, 120 mg or 240 mg once a day, or allopurinol 300 mg or 100 mg (depending upon renal function), or placebo for 28 weeks.
The patients had serum urate levels of at least 8.0 mg/dL, and the primary endpoint was serum urate levels below 6.0 mg/dL (i.e., below saturating level) at the three most recent exams.
Among patients with normal renal function, the primary endpoint was achieved by 48% on febuxostat 80 mg, 65% on 120 mg and 69% on 240 mg, while 22% of patients on allopurinol and none of those on placebo met the endpoint.
Among patients with impaired renal function, 44% of those on febuxostat 80 mg, 45% of those on 120 mg and 60% of those on 240 mg achieved the primary endpoint, while none of the patients on allopurinol did so.
Adverse event rates were similar across all groups, although diarrhea and dizziness were more frequent in the febuxostat 240 mg group.
"In contrast to allopurinol, febuxostat inhibits both oxidized and reduced forms of xanthine oxidase and has minimal effects on other enzymes of purine and pyrimidine metabolism," Dr. Schumacher explained. However, he noted, "Febuxostat should not be used with allopurinol as other mechanisms are similar."
"The efficacy of febuxostat in subjects with renal impairment is promising and warrants further study," Dr. Schumacher said, but he told Reuters Health that "no other studies are planned that I know."
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου