Should doctors rethink the standard gout treatment?
Gout is caused by the accumulation of urate crystals in the joints, and xanthine oxidase inhibitors such as febuxostat are a staple treatment to help lower blood urate levels in afflicted people. However, a new clinical trial reported in Arthritis & Rheumatology suggests that benzbromarone, a less popular medication, may be better in low dosages.
In the prospective single-center, open-labeled trial, 196 men with gout and poor uric acid excretion were randomized to receive either low-dose benzbromarone (LDBen) or low-dose febuxostat (LDFeb) for 12 weeks.
Compared to the LDFeb group, more individuals in the LDBen group met the blood urate objective of 6 mg/dL (32% vs 61%). There was no major difference in side effects across 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 wrote.
Reference: “Superiority of low-dose benzbromarone to low-dose febuxostat in a prospective, randomized comparative effectiveness trial in gout patients with renal uric acid underexcretion” by Fei Yan MD, Xiaomei Xue MD, Jie Lu MD, Nicola Dalbeth MD, Han Qi MS, Qing Yu MS, Can Wang MD, Mingshu Sun MD, Lingling Cui Ph.D., Zhen Liu Ph.D., Yuwei He Ph.D., Xuan Yuan MD, Ying Chen MD, Xiaoyu Cheng MD, Lidan Ma MD, Hailong Li Ph.D., Aichang Ji Ph.D., Shuhui Hu MS, Zijing Ran MS, Robert Terkeltaub Ph.D. and Changgui Li MD, 7 July 2022, Arthritis & Rheumatology.