Should clinicians reconsider standard therapy for gout?

Gout occurs when urate crystals accumulate in the joints, and xanthine oxidase inhibitors such as febuxostat are a mainstay of therapy to help reduce blood urate levels in affected patients. A recent clinical trial published in Arthritis & Rheumatology has found that low doses of a less commonly used drug called benzbromarone may be a better option, however.

In the prospective single-center, open-labeled trial, 196 men with gout and low urinary excretion of uric acid were randomized to receive low-dose benzbromarone (LDBen) or low-dose febuxostat (LDFeb) for 12 weeks.

More participants in the LDBen group achieved the blood urate target of < 6 mg/dL than those in the low-dose febuxostat group (61% versus 32%). Side effects typically did not differ between the groups.

The results suggest that low dosing of benzbromarone may warrant stronger consideration as a safe and effective therapy to achieve serum urate target in gout, the authors concluded.

Reference: "Superiority of low-dose benzbromarone to febuxostat in a prospective, comparative effectiveness trial in gout patients with renal urate underexcretion"; Arthritis & Rheumatology; DOI:10.1002/art.42266.