期刊連結：http://www.gouthyperuricemia.org

Objective: To compare the efficacy and safety of febuxostat, allopurinol and benzbromarone in urate-lowering therapies (ULTs).

Methods: This was a retrospective cohort study of 206 patients with primary gout. There were 92 patients using febuxostat 40mg (group A), 70 patients using allopurinol 250mg (group B), 25 patients using benzbromarone 25mg (group C), and 19 patients using benzbromarone 25-50mg (group D). General information and urate levels were collected three times: before ULT, one month after ULT, and three months after ULT. Serum uric acid (sUA) reduction and the proportion of patients at target were then evaluated. The rate of developing liver or renal damage after one month ULTs were computed and compared in these groups.

Results: Urate levels in each group decreased dramatically (183.95 ± 83.73μmol/L~200.68 ± 120.44μmol/L) one month after ULTs (β=-194.86~-183.95; p<0.001), but the decline ranges were not statically significant among these groups (β=-16.73~13.12; p>0.05). Three months after ULTs, urate levels did not decrease further (β=-4.09~20.70; p>0.05). The percentages of patients at target (6mg/dL) were 66.03% (A), 79% (B), 54.56% (C), and 66.7% (D) in the respective subgroups (UA≤540); 51.61% (A), 47.06% (B), 50% (C), and 66.67% (D) in the respective subgroups had UA>540 (OR=0.28~1.04, p=0.067~0.964); The rates of developing liver damage were 13.30% (A), 20.50% (B), and 26.10% (C and D), and renal damage rates were 8.6% (A), 13.00% (B), and 8.82% (C and D); We did not observe significant differences in the damage rates among three groups, but the effects sizes indicate that the rate of both liver damage and renal damage were lower when on febuxostat.

Conclusion: Febuxostat 40mg, allopurinol 250mg and benzbromarone 25-50mg have similar efficacy for ULTs; Febuxostat seems to be safer for ULTs.