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char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = .;code = 46
result sql = Febuxostat: the evidence for its use in the treatment of hyperuricemia and gout.
Febuxostat: the evidence for its use in the treatment of hyperuricemia and gout.
char = <;code = 60
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char = R;code = 82
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char = U;code = 85
char = C;code = 67
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char = g;code = 103
char = ;code = 32
char = f;code = 102
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char = o;code = 111
char = r;code = 114
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char = b;code = 98
char = e;code = 101
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char = g;code = 103
char = ;code = 32
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char = c;code = 99
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char = a;code = 97
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char = O;code = 79
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char = n;code = 110
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char = 0;code = 48
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char = n;code = 110
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char = a;code = 97
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char = c;code = 99
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char = r;code = 114
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char = c;code = 99
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char = a;code = 97
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char = ;code = 32
char = s;code = 115
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char = i;code = 105
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char = l;code = 108
char = a;code = 97
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char = e;code = 101
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char = e;code = 101
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char = s;code = 115
char = ,;code = 44
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char = o;code = 111
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char = .;code = 46
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char = <;code = 60
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char = >;code = 62
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char = >;code = 62
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char = V;code = 86
char = I;code = 73
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char = E;code = 69
char = N;code = 78
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char = ;code = 32
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char = V;code = 86
char = I;code = 73
char = E;code = 69
char = W;code = 87
char = ;code = 32
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char = ;code = 32
char = <;code = 60
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char = e;code = 101
char = b;code = 98
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char = o;code = 111
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char = a;code = 97
char = t;code = 116
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char = d;code = 100
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char = g;code = 103
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char = r;code = 114
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char = ;code = 32
char = 4;code = 52
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char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
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char = ;code = 32
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char = i;code = 105
char = s;code = 115
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char = f;code = 102
char = f;code = 102
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char = c;code = 99
char = a;code = 97
char = c;code = 99
char = i;code = 105
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = d;code = 100
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char = c;code = 99
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
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char = m;code = 109
char = ;code = 32
char = u;code = 117
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char = t;code = 116
char = e;code = 101
char = ;code = 32
char = i;code = 105
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char = ;code = 32
char = p;code = 112
char = a;code = 97
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char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
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char = w;code = 119
char = i;code = 105
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char = h;code = 104
char = ;code = 32
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = ,;code = 44
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = f;code = 102
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char = v;code = 118
char = o;code = 111
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char = a;code = 97
char = b;code = 98
char = l;code = 108
char = y;code = 121
char = ;code = 32
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char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = x;code = 120
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char = ;code = 32
char = d;code = 100
char = o;code = 111
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char = s;code = 115
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char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
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char = p;code = 112
char = u;code = 117
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char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
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char = n;code = 110
char = ;code = 32
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char = a;code = 97
char = t;code = 116
char = ;code = 32
char = r;code = 114
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char = p;code = 112
char = e;code = 101
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char = .;code = 46
char = ;code = 32
char = E;code = 69
char = a;code = 97
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char = l;code = 108
char = y;code = 121
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char = a;code = 97
char = f;code = 102
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char = s;code = 115
char = i;code = 105
char = g;code = 103
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char = a;code = 97
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
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char = r;code = 114
char = e;code = 101
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char = p;code = 112
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = ;code = 32
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char = o;code = 111
char = ;code = 32
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char = v;code = 118
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char = ;code = 32
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char = s;code = 115
char = t;code = 116
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char = a;code = 97
char = b;code = 98
char = n;code = 110
char = o;code = 111
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char = a;code = 97
char = l;code = 108
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char = t;code = 116
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
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char = r;code = 114
char = d;code = 100
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char = l;code = 108
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char = p;code = 112
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char = <;code = 60
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char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = C;code = 67
char = L;code = 76
char = I;code = 73
char = N;code = 78
char = I;code = 73
char = C;code = 67
char = A;code = 65
char = L;code = 76
char = ;code = 32
char = P;code = 80
char = O;code = 79
char = T;code = 84
char = E;code = 69
char = N;code = 78
char = T;code = 84
char = I;code = 73
char = A;code = 65
char = L;code = 76
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = G;code = 71
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = e;code = 101
char = x;code = 120
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = e;code = 101
char = x;code = 120
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = l;code = 108
char = i;code = 105
char = k;code = 107
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = m;code = 109
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = r;code = 114
char = s;code = 115
char = t;code = 116
char = -;code = 45
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = r;code = 114
char = u;code = 117
char = g;code = 103
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = e;code = 101
char = b;code = 98
char = u;code = 117
char = x;code = 120
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = v;code = 118
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char = d;code = 100
char = e;code = 101
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char = a;code = 97
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = p;code = 112
char = o;code = 111
char = r;code = 114
char = t;code = 116
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
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char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
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char = u;code = 117
char = n;code = 110
char = a;code = 97
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = p;code = 112
char = h;code = 104
char = i;code = 105
char = .;code = 46
result sql = INTRODUCTION : Gout is a common and disabling cause of arthritis in middle-aged and elderly populations, with its main predisposing factor being hyperuricemia (serum urate > 6.8 mg/dL). Options for treatment of chronic gout until 2008 were allopurinol, a xanthine oxidase inhibitor, and the group of drugs known as uricosurics that stimulate the renal excretion of uric acid. A proportion of patients, including some with chronic kidney disease and solid organ transplantations, could not be treated with the those therapies because of intolerance, drug interactions, or adverse events. Febuxostat is a nonpurine xanthine oxidase inhibitor, recently approved in Europe and the United States for the treatment of chronic gout.

AIM : To review the clinical evidence (phase II and III studies) of the effectiveness and safety of febuxostat for treatment of hyperuricemia and gout.

EVIDENCE REVIEW : Febuxostat, at doses ranging from 40 to 240 mg/day, is efficacious in reducing serum urate in patients with hyperuricemia and gout, comparing favorably with fixed doses of allopurinol in that respect. Early safety signals with respect to liver test abnormalities and cardiovascular outcomes have not been confirmed in recent large prospective trials but need to be further monitored.

CLINICAL POTENTIAL : Given its low cost and extensive clinical experience, allopurinol will likely remain the first-line drug for management of hyperuricemia and gout. Febuxostat may provide an important option in patients unable to use allopurinol, those with very high serum urate levels, or in the presence of refractory tophi.

Publication: Core Evid 2010 ;4:25-36.
Publication Date: 2010
Study Author(s): Gaffo, Angelo L;Saag, Kenneth G;
Institution: Birmingham VA Medical Center.
Shortcut link to this study:
INTRODUCTION : Gout is a common and disabling cause of arthritis in middle-aged and elderly populations, with its main predisposing factor being hyperuricemia (serum urate > 6.8 mg/dL). Options for treatment of chronic gout until 2008 were allopurinol, a xanthine oxidase inhibitor, and the group of drugs known as uricosurics that stimulate the renal excretion of uric acid. A proportion of patients, including some with chronic kidney disease and solid organ transplantations, could not be treated with the those therapies because of intolerance, drug interactions, or adverse events. Febuxostat is a nonpurine xanthine oxidase inhibitor, recently approved in Europe and the United States for the treatment of chronic gout.

AIM : To review the clinical evidence (phase II and III studies) of the effectiveness and safety of febuxostat for treatment of hyperuricemia and gout.

EVIDENCE REVIEW : Febuxostat, at doses ranging from 40 to 240 mg/day, is efficacious in reducing serum urate in patients with hyperuricemia and gout, comparing favorably with fixed doses of allopurinol in that respect. Early safety signals with respect to liver test abnormalities and cardiovascular outcomes have not been confirmed in recent large prospective trials but need to be further monitored.

CLINICAL POTENTIAL : Given its low cost and extensive clinical experience, allopurinol will likely remain the first-line drug for management of hyperuricemia and gout. Febuxostat may provide an important option in patients unable to use allopurinol, those with very high serum urate levels, or in the presence of refractory tophi.
PMID: 20694062

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