It has taken a very long time for a major new gout drug to be developed and approved. Probably the best gout news in over 40 years, is that Febuxostat, which has been given the trade/brand name of Adenuric, has been approved by the European Medicines Agency for marketing in European Union (EU) countries.

This approval applies only to EU countries. Febuxostat has not yet been approved in the United States. If you are reading this from a non-EU country, or the US, you can check with your doctor to find out whether, or when, Febuxostat will be approved in your country.

Approval in one country does not mean approval in another, but the fact that the European Medicines Agency has approved it will carry weight when the medical authorities in other countries consider its approval.

BENEFITS

In large trials Febuxostat (Adenuric) has outperformed Allopurinol, the most common gout medication for long term treatment. Like Allopurinol, it works to lower uric acid production by inhibiting xanthine oxidase, an enzyme required to produce uric acid. In two major studies it reduced uric acid (UA) in more gout sufferers, and more patients reached the target 6.0 mg/dL level more quickly, than did those on Allopurinol.

At 120 mg it has reduced UA levels to the target of 6.0 mg/dL in over 60% of study patients. At 80 mg the numbers were around 51%. Allopurinol at a 300 mg dosage in most participants achieved this is 22% of study patients. Hence the excited buzz in rheumatology circles since these kinds of results became apparent in its trials. At or below 6.0 mg/dL gout is more likely to be cured or managed better.

Generally, Febuxostat has been more effective when UA levels are below 10.0 mg/dL (595 mmol/µmol). However, even if they have been above this level, it has reduced UA levels down to the target in about 40% of study patients at an 80 mg dosage, and by more at higher dosages.

IT'S NOT PERFECT

In trials its success rate in reducing UA levels down to the important 6.0 mg/dL (357 mmol/µmol) level was not 100%. About 35% of trial patients did not achieve the target. This may have been partly because so many gout sufferers are not UA over-producers, the problem Febuxostat addresses, but under-excretors of uric acid.

And it may cause side effects of course. See the bottom of this article.

Febuxostat (Adenuric) is not unfortunately a treatment for gout pain. It won't be used instead of NSAIDS like Indomethacin, Colchicine, and corticosteroids.

It is recommended that NSAIDs or Colchicine are used along with Adenuric. This is because, as with Allopurinol, on a course of Febuxostat, there may be an initial increase in gout flares. If this happens you must battle through the attacks and continue taking Adenuric.

It will also only be used in gout patients who have chronic hyperuricemia (high UA levels) and gout.

So if you're a gout sufferer who lives in a European country that's a member of the EU, you can ask your doctor's opinion about whether Febuxostat is suitable for you.

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