Diabetes and gout: efficacy and safety of febuxostat and allopurinol
Article first published online: 12 JUN 2013
© 2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Diabetes, Obesity and Metabolism
Volume 15, Issue 11, pages 1049–1055, November 2013
How to Cite
Becker, M. A., MacDonald, P. A., Hunt, B. J. and Jackson, R. L. (2013), Diabetes and gout: efficacy and safety of febuxostat and allopurinol. Diabetes, Obesity and Metabolism, 15: 1049–1055. doi: 10.1111/dom.12135
- Issue published online: 7 OCT 2013
- Article first published online: 12 JUN 2013
- Accepted manuscript online: 17 MAY 2013 01:02PM EST
- Manuscript Accepted: 14 MAY 2013
- Manuscript Revised: 22 APR 2013
- Manuscript Received: 11 FEB 2013
- Takeda Global Research & Development Center, Inc.
- clinical trial;
- diabetes mellitus;
- drug utilisation
Assess influences of demographics and co-morbidities of gout patients with or without diabetes on safety and efficacy of urate-lowering agents.
Post-hoc analysis of 312 diabetic and 1957 non-diabetic gout patients [baseline serum urate levels (sUA) ≥8.0 mg/dl] enrolled in a 6-month randomized controlled trial comparing urate-lowering efficacy (ULE) and safety of daily xanthine oxidase inhibitors (XOIs) febuxostat (40 mg or 80 mg) and allopurinol (200 mg or 300 mg). We compared baseline demographic, gout and co-morbid characteristics, ULE, and safety of XOI treatment in diabetic and non-diabetic gout patients. ULE was measured by the proportion of diabetic and non-diabetic patients in each treatment group achieving final visit sUA < 6.0 mg/dl. Safety was monitored throughout the trial.
Diabetic gout patients were older, more frequently female, and had longer gout duration. Co-morbidities were more frequent among diabetic patients: cardiovascular disease; impaired renal function; hyperlipidemia; and obesity (body mass index >30 kg/m2) (p < 0.001 for all comparisons). Febuxostat 80 mg ULE exceeded that of febuxostat 40 mg or allopurinol (p < 0.050) at all levels of renal function, achieving sUA goal range in the majority of diabetic and non-diabetic patients. Diabetics and non-diabetics reported self-limiting diarrhoea and URIs as the most common adverse events.
Despite higher co-morbidity rates in diabetic patients, febuxostat and allopurinol were safe in both groups at the doses tested. Febuxostat 80 mg achieved sUA <6.0 mg/dl more often than febuxostat 40 mg or allopurinol at commonly prescribed doses.