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 LDFeb 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 wrote.
Yan, F., et al. (2022) Superiority of low-dose benzbromarone to febuxostat in a prospective, comparative effectiveness trial in gout patients with renal urate underexcretion. Arthritis & Rheumatology. doi.org/10.1002/art.42266.