非布司他治疗痛风效果好吗？

The most common adverse reactions in patients with gout are abnormal liver function, rash, diarrhea, headache, nausea, vomiting, abdominal pain, dizziness, joint pain and musculoskeletal symptoms. Most of the adverse reactions are mild to moderate. So, is febuxostat effective in treating gout?

Research results show that long-term use of febuxostat can maintain long-term blood uric acid in most patients at ≤6.0 mg/dl. Mild to moderate impairment of renal function has no significant impact on the pharmacodynamics and pharmacokinetics of febuxostat. Therefore, the uric acid-lowering effect of febuxostat is no different from that of patients with normal renal function, and its safety is good.

Due to the limitations of allopurinol application, there is an urgent need for the emergence of new urate-lowering drugs. Febuxostat is a non-purine xanthine oxidase inhibitor. Its launch provides a new option for gout patients. It has been approved by the European Union and the United States for the treatment of gout and hyperuricemia.

Moreover, febuxostat has a better uric acid-lowering effect than allopurinol without serious adverse reactions, and has been fully used clinically. The currently recommended application method is: the initial dose is 40 mg/d. If the blood uric acid still does not reach ≤6.0 mg/dl after 2 weeks, increase the dose to 80 mg/d.

Febuxostat is mainly metabolized by the liver and does not rely on renal excretion. Therefore, it is safe and effective in patients with mild to moderate renal insufficiency, and no dose adjustment is required. Clinically, febuxostat should be considered for patients with mild to moderate renal impairment, allopurinol intolerance, and current treatments that cannot maintain blood uric acid at the target value.

In addition, when febuxostat is used to treat hyperuricemia, it may easily lead to an acute attack of gout in the early stages. Therefore, it is recommended that patients taking febuxostat take colchicine or NSAIDs during the first 6 months of treatment to avoid acute attacks of gout.

A study reported that among 13 gout patients who experienced severe adverse reactions during allopurinol treatment, 12 patients no longer experienced serious adverse reactions after the treatment was adjusted, and the drug was well tolerated.