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Diabetes and gout: efficacy and safety of febuxostat and allopurinol
Author(s) -
Becker M. A.,
MacDonald P. A.,
Hunt B. J.,
Jackson R. L.
Publication year - 2013
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12135
Subject(s) - febuxostat , gout , medicine , allopurinol , xanthine oxidase inhibitor , diabetes mellitus , uric acid , hyperuricemia , xanthine oxidase , renal function , surgery , endocrinology , biochemistry , chemistry , enzyme
Aim Assess influences of demographics and co‐morbidities of gout patients with or without diabetes on safety and efficacy of urate‐lowering agents. Methods Post‐hoc analysis of 312 diabetic and 1957 non‐diabetic gout patients [baseline serum urate levels ( sUA ) ≥8.0 mg/dl] enrolled in a 6‐month randomized controlled trial comparing urate‐lowering efficacy ( ULE ) and safety of daily xanthine oxidase inhibitors ( XOIs ) febuxostat (40 mg or 80 mg) and allopurinol (200 mg or 300 mg). We compared baseline demographic, gout and co‐morbid characteristics, ULE , and safety of XOI treatment in diabetic and non‐diabetic gout patients. ULE was measured by the proportion of diabetic and non‐diabetic patients in each treatment group achieving final visit sUA < 6.0 mg/dl. Safety was monitored throughout the trial. Results Diabetic gout patients were older, more frequently female, and had longer gout duration. Co‐morbidities were more frequent among diabetic patients: cardiovascular disease; impaired renal function; hyperlipidemia; and obesity (body mass index >30 kg/m 2 ) (p < 0.001 for all comparisons). Febuxostat 80 mg ULE exceeded that of febuxostat 40 mg or allopurinol (p < 0.050) at all levels of renal function, achieving sUA goal range in the majority of diabetic and non‐diabetic patients. Diabetics and non‐diabetics reported self‐limiting diarrhoea and URIs as the most common adverse events. Conclusions Despite higher co‐morbidity rates in diabetic patients, febuxostat and allopurinol were safe in both groups at the doses tested. Febuxostat 80 mg achieved sUA <6.0 mg/dl more often than febuxostat 40 mg or allopurinol at commonly prescribed doses.