Acute flares do not last long on febuxostat

21 Jan 2021
Acute flares do not last long on febuxostat

In patients with gout, treatment with febuxostat does not appear to prolong the duration of acute flares, a study has shown.

A total of 140 patients with acute gout flares were randomized to receive febuxostat (40 mg/day; n=70) or placebo (n=70) within 72 hours of index event. All patients were given diclofenac (150 mg/day) for 7 days and then open-labelled on the 8th day.

From day 8 through 28, febuxostat 40 mg and diclofenac 75 mg were administered once daily in patients in remission. Those who did not achieve it continued to receive diclofenac at 150 mg/day until remission.

The primary outcome of mean days to resolution did not significantly differ between the treatment arms (5.98 days with placebo vs 6.50 days with febuxostat; p=0.578). The rate of resolution within 7 days was 84.38 percent versus 76.92 percent, respectively (p=0.284).

Likewise, joint pain, swelling, tenderness, and erythema scores at days 1, 3, 5, and 7 were similar in the treatment groups.

However, febuxostat use led to a significantly lower mean serum uric acid levels on day 7 (362.62 vs 507.54 μmol/l with placebo; p=0.000) and rate of recurrent gout flares from day 8 through 28 (6.56 percent vs 10.00 percent; p=0.492).

The present data suggest that the drug has the potential increase patient compliance to treatment.

Rheumatology 2021;doi:10.1093/rheumatology/keaa908