Gout overview and review of the CONFIRMS trial from Aneet Kaur
CONFIRMS trial paper can be found here
A few summary comments were these (I will attempt to paraphrase from Dr. Lipsmeyer's comments):
Febuxostat lowered serum uric acid level more than allopurinol in this randomized controlled trial. However, the doses of allopurinol used were probably below those that would be used in the real world, and and they (probably deliberately) didn't measure more clinically relevant outcomes like number of gout flares. It may be true that febuxostat has an advantage of making a lab number look better without actually improving clinically relevant outcomes. Still, it is a great drug to consider in the setting of substantial renal impairment.
CONFIRMS trial paper can be found here
A few summary comments were these (I will attempt to paraphrase from Dr. Lipsmeyer's comments):
Febuxostat lowered serum uric acid level more than allopurinol in this randomized controlled trial. However, the doses of allopurinol used were probably below those that would be used in the real world, and and they (probably deliberately) didn't measure more clinically relevant outcomes like number of gout flares. It may be true that febuxostat has an advantage of making a lab number look better without actually improving clinically relevant outcomes. Still, it is a great drug to consider in the setting of substantial renal impairment.
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