title: Efficacy and tolerability of febuxostat in hyperuricemic patients with or without gout: a systematic review and meta-analysis.
abstract: BACKGROUND
  Febuxostat has been approved for the treatment of hyperuricemia in patients with/without gout.
  
  
  OBJECTIVE
  This meta-analysis and systematic review assessed the efficacy and tolerability of febuxostat in hyperuricemic patients with/without gout.
  
  
  METHODS
  Major electronic databases were searched for articles of all publication years (up to February 2012), as were the Web sites of the American College of Rheumatology, the European League Against Rheumatism, and the Chinese State Food and Drug Administration, and clinicaltrials.gov for unpublished studies. Only randomized, controlled trials (RCTs) were included.
  
  
  RESULTS
  Ten trials were included. A significantly greater proportion of patients achieved the target serum urate level (sUA ≤6.0 mg/dL) at the final visit in the febuxostat group compared with the placebo (OR = 235.73; P < 0.01) and allopurinol groups (OR = 3.14; P < 0.01). In subgroup analysis, the proportion of patients who achieved target sUA at the final visit was significantly greater in the febuxostat-treated group (40 mg/d) compared with the allopurinol-treated group (100-300 mg/d) (50.9% vs 45.6%; OR = 1.25; 95% CI, 1.05-1.49; P = 0.01). As the dosage was increased (40, 80, 120 mg/d), the proportion of patients who achieved target sUA in the febuxostat-treated group increased gradually (50.9%, 71.4%, 82%, respectively). There was no significant difference in the occurrence of adverse events (AEs) between the febuxostat- and allopurinol-treated groups.
  
  
  CONCLUSIONS
  Febuxostat was effective in reducing serum urate in hyperuricemic patients with/without gout, and febuxostat (40-120 mg/d) was more efficacious compared with allopurinol (100-300 mg/d). The doses of allopurinol to which febuxostat has been compared, although commonly prescribed, are low in the range of approved doses of allopurinol. The tolerability of febuxostat for the treatment of hyperuricemia with/without gout is similar to that of allopurinol.
authors: Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors: Peng
authors: P
authors: Ye
authors: Shumin
authors: S
authors: Yang
authors: Wenlong
authors: W
authors: Zhang
authors: Qiong
authors: Q
authors: Lv
authors: Qingfeng
authors: Q
authors: Cheng
authors: Mei
authors: M
authors: Mei
authors: Ting
authors: T
authors: Luo
authors: Lulu
authors: L
authors: Liu
authors: Shumei
authors: S
authors: Chen
authors: Qifu
authors: Q
authors: Li
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000453:epidemiology*; D006074:Gout Suppressants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood
chemical_list: D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D014527:Uric Acid; D000493:Allopurinol