The role of febuxostat in gout

Purpose of review Concerns about the cardiovascular safety of febuxostat lead to reconsideration of the place of febuxostat in the management of gout. Recent findings The CARES trial is a randomized controlled trial mandated by the FDA to compare the cardiovascular safety of febuxostat and allopurinol in the management of gout. About 6190 patients with gout and major cardiovascular disease, randomly assigned to allopurinol or febuxostat, were prospectively followed up for a median of 32 months. No difference was noted in the occurrence of the primary end-point event, a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization, but cardiovascular death was significantly more common in the febuxostat group (4.3%) as compared with the allopurinol group (3.2%) (Pā€Š=ā€Š0.03). Summary Present guidelines on the management of gout should be revised in view of recent findings. Allopurinol could be recommended as the sole first-line urate-lowering drug (ULD) in patients with no contraindication. In patients contraindicated to allopurinol, uricosurics could be preferred to febuxostat as first-line ULDs in patients with cardiovascular disease/risk factors and no history of uric acid stones.
Source: Current Opinion in Rheumatology - Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research

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Eur J Intern Med. 2021 Oct 14:S0953-6205(21)00332-0. doi: 10.1016/j.ejim.2021.10.002. Online ahead of print.ABSTRACTColchicine is an old, inexpensive, and relatively safe anti-inflammatory drug traditionally used in gout and over the last 50 years in familial Mediterranean fever. A search of all high-hierarchy studies (randomized controlled trials [RCTs], systematic reviews and meta-analysis of RCTs) over the last 20 years revealed myriad other evidence-based applications. Colchicine seems efficacious in the treatment of acute pericarditis and prevention of recurrences and the prevention of postcardiac injury syndrome and ...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Source Type: research
AbstractHyperuricemia and gout have been linked to an increased risk for cardiovascular (CV) disease, stroke, hypertension, heart failure, and chronic kidney disease, possibly through a proinflammatory milieu. However, not all the drugs used in gout treatment improve CV outcomes; colchicine has shown improved CV outcomes in patients with recent myocardial infarction and stable coronary artery disease independent of lipid-lowering effects. There is resurging interest in colchicine following publication of the COLCOT, LoDoCo, LoDoCo2, LoDoCo-MI trials,  and COLCORONA trial which will shed light on its utility in CO...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
Here’s a recent headline that I found confusing: Could the first drug that slows arthritis be here? It’s confusing because it depends on which of the more than 100 types of arthritis we’re discussing. We’ve had drugs that slow rheumatoid arthritis for decades. In fact, more than a dozen FDA-approved drugs can reduce, or even halt, joint damage in people with rheumatoid arthritis. We also have effective medications to slow or stop gout, another common type of arthritis. But the headline refers to osteoarthritis, the most common type of arthritis. And currently, no medications can safely and reliably ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Arthritis Health Inflammation Source Type: blogs
In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease. PMID: 32739239 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Abstract Chronic inflammation plays an extensive role in the onset and progression of metabolic disorders such as atherosclerosis, type 2 diabetes, gout and obesity. Atherosclerosis accounts for upwards of 70% mortality in patients with type 2 diabetes and is also a chronic condition that causes atrial stenosis due to a lipometabolism imbalance. The purpose of this article is to consider the inflammatory factors implicated in atherosclerosis and their role in the development and progression of this vascular disease. The inflammasome signaling pathway is an important inflammatory mechanism involved in the developme...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
The inflammation-fighting drug colchicine, already a treatment for gout, dramatically reduces the odds of future cardiovascular problems in people who have just survived a heart attack, a large new study by a Montreal researcher has concluded.
Source: CBC | Health - Category: Consumer Health News Tags: News/Health Source Type: news
(Reuters Health) - The inflammation-fighting drug colchicine, already a treatment for gout, dramatically reduces the odds of future cardiovascular problems in people who have just survived a heart attack, a large new study has concluded.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
In the new trial, colchicine reduced by as much as 34% a heart attack survivor's combined risk of either dying from heart disease or having cardiac arrest, a heart attack, a stroke or angioplasty.
Source: WebMD Health - Category: Consumer Health News Source Type: news
Abstract Light and Shadow of Hyperuricemia - Neuroprotection, Comorbidities and Therapeutic Strategies Abstract. Hyperuricemia can lead to gout but also favor the appearance of comorbidities like hypertension, kidney insufficiency, type 2 diabetes, myocardial infarction and strokes. Uric acid does not only have, however, negative impact on the body, but seems to influence positively certain inflammatory and degenerative neurological diseases. The inflammatory reaction at the center of a gout attack is mediated by interleukin 1. Therefore, antagonists against interleukin 1 or IL-1 receptors can be used for treatmen...
Source: Praxis - Category: General Medicine Authors: Tags: Praxis (Bern 1994) Source Type: research
This study shows that mRNA levels of the aging related lamin A splice variant progerin, associated with premature aging in HGPS, were significantly upregulated in subjects with BMI ≥ 25 kg/m2. Moreover, our data revealed a significantly positive correlation of BMI with progerin mRNA. These data provide to our knowledge for the first-time evidence for a possible involvement of progerin in previously observed accelerated aging of overweight and obese individuals potentially limiting their longevity. Our results also showed that progerin mRNA was positively correlated with C-reactive protein (CRP). This might suggest an as...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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