Choosing the optimal urate-lowering therapy for patients with gout

The editors of the «Ukrainian rheumatological journal»

Summary. Management of patients with gout involves the mandatory appointment of pathogenetic therapy — urate-lowering drugs, among which are widely used xanthine oxidase inhibitors: allopurinol and febuxostat. Febuxostat is a potent selective xanthine oxidase inhibitor. The article reviews the literature on the main clinical trials of this drug, demonstrate the possible use of it in patients with impaired renal function, intolerance and high risk of severe skin reactions or resistance to allopurinol. Patients with reduced renal function have a high risk of death and a low probability of reaching the target uric acid level when allopurinol is prescribed. Given that febuxostat has a nephroprotective effect, its appointment in such patients may be appropriate, as it could help to achieve better control of uric acid levels in serum.