New Gout Drug Twice as Effective
Febuxostat More Effective at Reducing Uric Acid Levels Than Standard Gout Drug
Nov. 16, 2005 -- A new treatment for gout is at
least twice as effective at lowering uric acid levels as the standard drug
allopurinol, according to results from the longest and largest trial of such
drugs ever conducted.
The drug, febuxostat, will likely be the first new agent available to treat
gout in more than 40 years, says researcher Robert L. Wortmann, MD, professor
and chairman of the department of rheumatology at the University of Oklahoma in
Exactly when the new drug will be approved is not known, but "personally
I am optimistic," he says.
The research was presented at the annual meeting of the American College of
Rheumatology in San Diego.
Lowering Uric Acid Is Key to Gout Control
Affecting more than 5 million Americans, gout is a chronic arthritic
condition characterized by "flares" of intense pain, redness,
inflammation, and warmth in the affected joint. Typically, symptoms begin in
the big toe, but gout may strike other joints.
Gout is caused by an accumulation of uric acid crystals in the affected
joint(s). As the disease progresses, these flares may become more frequent and
patients may develop joint deformity and large deposits of crystals, which can
become visible under the skin (called tophi).
Uric acid is found naturally in the body. In gout, there is generally a
problem with either too much production of uric acid or problems in getting rid
of the uric acid, or both.
"When you have gout, there's too much uric acid in the body,"
Wortmann explains to WebMD. "Uric acid is like matches, and for some
reason, one of these matches strike and you get a hot foot."
"We treat the fire with anti-inflammatory drugs or colchicine right away
because if not, more matches will catch and the fire will get worse," he
explains. Though "these medications can put out the fire, it doesn't get
rid of the matches so they still can strike."
Enter febuxostat and allopurinol. And getting rid of these matches is what
febuxostat appears to do more effectively than allopurinol, according to the
Febuxostat Hits Target
In the 28-week study, 1,067 people with gout received either placebo (fake)
pills, allopurinol, or one of three doses of febuxostat (80, 120, or 240
milligrams). At all three doses, the new agent was more effective at bringing
uric acid levels down than allopurinol and placebo.
By the end of the study, 48% of people who took 80 milligrams of febuxostat
a day hit their target uric acid level, as did 65% of those taking 120
milligrams per day and 69% of those taking 240 milligrams per day. By contrast,
just 22% of participants taking allpurinol hit their mark, and zero people in
the placebo group did. What's more, side effects were equal across all
Like allopurinol, febuxostat would be a maintenance medication for gout.