Febuxostat Fixes Gout

Febuxostat has, like all new drugs, been subject to extensive testing [1]. Of course, allopurinol has been tested in real life for over 40 years, and is generally well tolerated. If you are one of the few who cannot tolerate allopurinol, then febuxostat may well be your best way to reduce uric acid to a safe level.

Research continues into the long term effects of febuxostat around the world, and I’ll post new information here as it becomes available. It is also discussed frequently in the gout cures forum, so you can see the real life experiences of other gout patients. Search for febuxostat OR Uloric OR Adenuric to get the latest views. Just copy the search query in italics into the search box at the top of the page.

Febuxostat Side-Effects

In a 2008 review, Hu & Tomlinson note that no serious side-effects of febuxostat have been found [2]. The mild to moderate adverse events are recorded as:

• Abnormal liver function tests
• Diarrhea
• Headache

This list is extended in Reinders & Jansen’s 2009 review of febuxostat and allopurinol [3] to:

1. Liver function abnormalities (3.5%)
2. Diarrhea (2.7%)
3. Headache (1.8%)
4. Nausea (1.7%)
5. Rash (1.5%)

They also add the warning that early trials raised heart disease concerns, but note that these were not repeated in later trials. Nevertheless, this concern is noted in the Uloric Prescribing Information [4]:

5.2 Cardiovascular Events
In the randomized controlled studies, there was a higher rate of cardiovascular thromboembolic events (cardiovascular deaths, non-fatal myocardial infarctions, and non-fatal strokes) in patients treated with ULORIC [0.74 per 100 P-Y (95% CI 0.36-1.37)] than allopurinol [0.60 per 100 P-Y (95% CI 0.16-1.53)] [see Adverse Reactions (6.1)]. A causal relationship with ULORIC has not been established. Monitor for signs and symptoms of myocardial infarction (MI) and stroke.

Now, some people fear that this makes febuxostat dangerous, but that is not my interpretation. I believe the authorities are merely taking a cautious approach. The fact that gout patients taking Uloric are more likely to be monitored for early signs of heart disease implies that their overall risk should be lower than the general population. This is something that needs to be discussed with your doctor. Never lose sight of the fact that high uric acid itself is associated with higher risks of heart disease, yet nobody understands how these things are related. Your best health option is to reduce uric acid to safe levels and monitor all aspects of your health in conjunction with your doctor.

Remember, all uric acid lowering treatments might induce a gout attack, as dissolving uric acid crystals can provoke an immune system inflammatory reaction in the same way that newly formed crystals do. Learn about the different forms of gout pain relief elsewhere in this gout treatments section, and discuss options with your doctor.

Febuxostat: Next Steps

Being a new drug, there is still lots of ongoing research. I will report these back as amendments to this febuxostat part of the Gout Treatments section, or as febuxostat news articles.

If you have experienced either Uloric or Adenuric, or if you have questions about this gout medication, please join the febuxostat debate. Please read the gout debate guidelines before you contribute to the discussion.

Febuxostat: References

1. Author:

   Takeda Pharmaceuticals North America, Inc.

   Title:

   Briefing Document for Febuxostat.

   Published:

   Nov 2008.

   Full Report:

   Febuxostat Briefing Material

2. Author:

   Hu M, Tomlinson B.

   Title:

   Febuxostat in the management of hyperuricemia and chronic gout: a review.

   Published:

   Ther Clin Risk Manag. 2008 Dec;4(6):1209-20.

   Full report:

   Febuxostat Review

3. Author:

   Reinders MK, Jansen TL.

   Title:

   Management of hyperuricemia in gout: focus on febuxostat.

   Published:

   Clin Interv Aging. 2010 Feb 2;5:7-18.

   Full report:

   Febuxostat Versus Allopurinol

4. Author:

   Takeda Pharmaceuticals America, Inc.

   Title:

   Uloric Prescribing Information

   Published:

   Feb 2009.

   Full report:

   Uloric Prescribing Information