Description

Febuxostat is a non-purine selective xanthine oxidase inhibitor used for treating chronic gout in patients who cannot tolerate allopurinol. It works by inhibiting both oxidized and reduced forms of xanthine oxidase, effectively lowering serum uric acid levels. The CONFIRMS trial (Becker et al., 2010) demonstrated that febuxostat 80 mg daily was more effective than allopurinol 300 mg daily in achieving target serum urate levels, particularly in patients with mild to moderate renal impairment. However, a subsequent long-term safety study (White et al., 2018) raised concerns about increased cardiovascular risk with febuxostat compared to allopurinol. As a result, febuxostat is typically reserved for patients who cannot take allopurinol due to intolerance or contraindications. Patients should be informed about the potential cardiovascular risks and benefits before starting treatment.