A comparative study of efficacy of febuxostat and allopurinol regimens in patients of hyperuricemia

Abstract

Background: Gout, resulting from the precipitation of urate crystals in the tissues and the subsequent inflammatory response, causes an exquisitely painful distal monoarthritis alongwith joint destruction, subcutaneous deposits (tophi), renal calculi. The main culprit is uric Acid, which is a waste product formed due to purine metabolism. Gout Patients either produce excess Uric acid or are unable to excrete Uric acid produced in normal conditions. Uric acid lowering therapy (ULT) has become popular regarding management of gout. Nowadays. 2 drugs which are responsible for decreasing synthesis of Uric acid are Febuxostat and Allopurinol. The purpose of this study is to determine efficacy of Febuxostat and Allopurinol experienced by patients during course of therapy.Methods: It was an open, prospective, observational, non-invasive, parallel and randomised study, conducted at the Outpatient Department of Urology, Rajindra Hospital, Patiala. It had 60 patients of gout, out which, 30 patients were administered Febuxostat and 30 patients were administered Allopurinol. For each patient, history regarding drug intake was taken, along with analysis of Serum Uric acid profile before prescription and during follow up.Results: The mean age selected for study was 47 years for Febuxostat group and 43 years for Allopurinol group. Mean Urate (mg%) in pre-treatment stage of patients of Febuxostat group is about 8.28 whereas for Allopurinol group its about 8.61. Mean urate levels after 4 follow ups (10 days each) were conducted. The mean Urate level at 10, 20, 30, 40 days were conducted at each group which were found to be statistically significant and the results of Febuxostat group was found to be favourable.Conclusions: Febuxostat, (40mg) given at daily dose was found to have higher efficacy than allopurinol, at a dose of 100mg (zyloric) which is the most commonly prescribed dose in order to lower the serum urate level.