The role of febuxostat in gout

被引:30
作者
Bardin, Thomas [1 ,2 ,3 ]
Richette, Pascal [1 ,2 ,3 ]
机构
[1] Hop Lariboisiere, AP HP, Dept Rheumatol, Paris, France
[2] Univ Paris Diderot, Paris, France
[3] INSERM, U1132, Paris, France
关键词
allopurinol; cardiovascular disease; febuxostat; gout management; uricosurics; ALLOPURINOL DOSE-ESCALATION; SERUM URATE; CLINICAL PHARMACOKINETICS; ADVERSE EVENTS; DOUBLE-BLIND; OPEN-LABEL; PHASE-III; HYPERURICEMIA; RISK; HYPERSENSITIVITY;
D O I
10.1097/BOR.0000000000000573
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review Concerns about the cardiovascular safety of febuxostat lead to reconsideration of the place of febuxostat in the management of gout. Recent findings The CARES trial is a randomized controlled trial mandated by the FDA to compare the cardiovascular safety of febuxostat and allopurinol in the management of gout. About 6190 patients with gout and major cardiovascular disease, randomly assigned to allopurinol or febuxostat, were prospectively followed up for a median of 32 months. No difference was noted in the occurrence of the primary end - point event, a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization, but cardiovascular death was significantly more common in the febuxostat group (4.3%) as compared with the allopurinol group (3.2%) (P = 0.03). Summary Present guidelines on the management of gout should be revised in view of recent findings. Allopurinol could be recommended as the sole first - line urate - lowering drug (ULD) in patients with no contraindication. In patients contraindicated to allopurinol, uricosurics could be preferred to febuxostat as first - line ULDs in patients with cardiovascular disease/ risk factors and no history of uric acid stones.
引用
收藏
页码:152 / 158
页数:7
相关论文
共 44 条
[1]   Febuxostat Hypersensitivity [J].
Abeles, Aryeh M. .
JOURNAL OF RHEUMATOLOGY, 2012, 39 (03) :659-660
[2]  
Agency EM, AD EPAR PROD INF
[3]  
[Anonymous], SAF AL HUM MED PROD
[4]  
[Anonymous], 2013, REGISTRATION FILE MI
[5]   Lesinurad in combination with allopurinol: a randomised, double-blind, placebo-controlled study in patients with gout with inadequate response to standard of care (the multinational CLEAR 2 study) [J].
Bardin, Thomas ;
Keenan, Robert T. ;
Khanna, Puja P. ;
Kopicko, Jeff ;
Fung, Maple ;
Bhakta, Nihar ;
Adler, Scott ;
Storgard, Chris ;
Baumgartner, Scott ;
So, Alexander .
ANNALS OF THE RHEUMATIC DISEASES, 2017, 76 (05) :811-820
[6]   Risk of cutaneous adverse events with febuxostat treatment in patients with skin reaction to allopurinol. A retrospective, hospital-based study of 101 patients with consecutive allopurinol and febuxostat treatment [J].
Bardin, Thomas ;
Chales, Gerard ;
Pascart, Tristan ;
Flipo, Rene-Marc ;
Ea, Hang Korng ;
Roujeau, Jean-Claude ;
Delayen, Aurelie ;
Clerson, Pierre .
JOINT BONE SPINE, 2016, 83 (03) :314-317
[7]   Febuxostat compared with allopurinol in patients with hyperuricemia and gout [J].
Becker, MA ;
Schumacher, HR ;
Wortmann, RL ;
MacDonald, PA ;
Eustace, D ;
Palo, WA ;
Streit, J ;
Joseph-Ridge, N .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (23) :2450-2461
[8]   An open-label, 6-month study of allopurinol safety in gout: The LASSO study [J].
Becker, Michael A. ;
Fitz-Patrick, David ;
Choi, Hyon K. ;
Dalbeth, Nicola ;
Storgard, Chris ;
Cravets, Matt ;
Baumgartner, Scott .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 2015, 45 (02) :174-183
[9]   The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial [J].
Becker, Michael A. ;
Schumacher, H. Ralph ;
Espinoza, Luis R. ;
Wells, Alvin F. ;
MacDonald, Patricia ;
Lloyd, Eric ;
Lademacher, Christopher .
ARTHRITIS RESEARCH & THERAPY, 2010, 12 (02)
[10]   Safety and Efficacy of Febuxostat Treatment in Subjects with Gout and Severe Allopurinol Adverse Reactions [J].
Chohan, Saima .
JOURNAL OF RHEUMATOLOGY, 2011, 38 (09) :1957-1959