Febuxostat, a Non-Purine Selective Xanthine Oxidase Inhibitor in The Management of Hyperuricemia and Chronic Gout: A Systematic Review

Abstract

Febuxostat is a novel, potent, non-purine selective xanthine oxidase inhibitor which got approved for marketing in the year late 2009 by Central Drugs Standard Control Organization (CDSCO), India. Systematic search of trials/studies from PubMed and Cochrane database lead to 11 trials which demonstrated its superior ability to lower and maintain serum urate levels below 6 mg/dl compared with conventionally used doses of allopurinol for gout. Almost 45% of studies were of high quality according to Jadad score which proves the studies to be more authentic and reliable. The most common adverse reactions reported were abnormal liver function tests, headache, and gastrointestinal symptoms which were usually mild and transient. However, hepatotoxicity becomes a limitation in the use of febuxostat. Febuxostat seems to be a promising alternative for prescribing in primary care patients who are intolerant to allopurinol or to whom allopurinol is contraindicated but it should be associated with further long term surveillance for its safety and efficacy.