Effects of Febuxostat in early gout: A randomized, double-blind, placebo-controlled study

The urate-lowering therapy is most recommended therapy for the treatment of gout. However, these drugs were not provided up to mark relief from the gout symptoms. Therefore, a randomized study conducted by Dalbeth N et al used Febuxostat 40 mg and reported the significant improvement in magnetic resonance imaging (MRI) synovitis and reduced gout flares in gout patients. 

To evaluate the impact of Febuxostat versus placebo on joint damage among hyperuricemic patients with early gout.

A total of 314 participants with early gout and hyperuricemia were either received 40 mg Febuxostat, increased up to 80 mg if UA level was ≥6.0 mg/dl on day 14 or placebo. The primary outcome studied was the mean change in the modified Sharp/van der Heijde erosion score for the single affected joint from baseline to month 24. The change from baseline to month 24 in the erosion, the incidence of gout flares, Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) for synovitis, serum UA levels, and edema in the single affected joint were some of the additional efficacy outcomes that also evaluated during the analysis. Safety was evaluated all through the investigation.

No significant change was seen in the joint erosion over two years with the Febuxostat treatment. A minimal mean change was observed in the modified Sharp/van der Heijde erosion score from baseline to month 24 for the single affected joint, with no between-group variations. Although serum UA control improved, the overall incidence of gout flares reduced and RAMRIS synovitis score at month 24 improved with Febuxostat treatment as compared to the placebo. No significant safety concerns were recorded.

Urate-lowering treatment with Febuxostat decreased the incidence of gout flares and enhanced magnetic resonance imaging-determined synovitis among individuals with early gout.