The Medical Letter on Drugs and Therapeutics
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Febuxostat (Uloric) for Chronic Treatment of Gout

Febuxostat (Uloric – Takeda), a xanthine oxidase inhibitor, has been approved by the FDA for chronic management of hyperuricemia in patients with gout. It is the first drug marketed for treatment of gout in 40 years. Febuxostat is structurally unrelated to allopurinol, the only other commercially available inhibitor of xanthine oxidase. Xanthine oxidase inhibitors decrease serum urate concentrations by decreasing urate synthesis.

TREATMENT OF GOUT — Most acute attacks of gout can be managed with colchicine, nonsteroidal antiinflammatory drugs (NSAIDs) or corticosteroids.1 However, many patients have elevated uric acid levels that can eventually lead to frequent or refractory attacks, development of tophi (urate deposits that can form large subcutaneous nodules or erode into joints), uric acid renal calculi or other parenchymal involvement. Such patients may benefit from serum urate ... more      

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