Febuxostat use in gout patients may increase risk of hepatotoxicity: Study

A new study published in the journal of Arthritis Care & Research showed that in individuals with gout, usage of Febuxostat is linked to a noticeably higher risk of mild-to-moderate liver function disruption than using benzbromarone.

Despite the effectiveness and widespread availability of urate-lowering treatment (ULT), gout is still not well treated, in part due to worries about adverse medication reactions. Although it can result in a rare hypersensitivity syndrome that is more prevalent in those of Southeast Asian heritage, allopurinol is advised as the recommended first-line treatment. Allopurinol and Febuxostat are equally effective for ULT.

Metabolic dysfunction–associated steatohepatitis (MASH) affects around 25% of gout sufferers, and it may raise the risk of drug-induced liver damage. Therefore, it has been suggested that serum liver function tests (LFTs) be monitored during ULT. This study assessed the hepatotoxicity risk of benzbromarone and febuxostat usage in gout patients.

An electronic medical record database was used to identify new users of benzbromarone or febuxostat who had their liver function monitored at least three times within a year after starting the study medications. The two groups were matched 1:1 for age, sex, and pretreatment levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in order to perform propensity score matching (PSM). The chance of hepatotoxicity (defined as ALT or AST > 3× upper limit of normal) was estimated using Kaplan-Meier analysis. Based on comorbidities, body mass index, and age, subgroup analysis was carried out.