There's a new gout drug -Febuxostat

Febuxostat,144060-53-7

　　Febuxostat is a urate lowering drug, an inhibitor of xanthine oxidase that is indicated for use in the treatment of hyperuricemia and chronic gout.
　　For long suffering gout patients, perhaps the best gout news in 45 years is that this drug has been approved for marketing in those European countries that are members of the European Union (EU).
　　1.How good is febuxostat for gout?
    In trials, its success rate in reducing uric acid (UA) levels down to the important 6.0 mg/dL (0.357 mmol/L) level was not 100%.About 20%-28% of trial patients did not achieve the target at final visit.And it has been less successful in patients who have UA levels above 10.0 mg/dL, (0.595 mmol/L).But even when uric acid is above 10.0 mg/dL, it has reduced it down to the target in about 60%-67% of study patients at an 80 mg dosage, and by more at higher dosages.Pretty good going.
　　Remember that Febuxostat is NOT a treatment for gout pain – so it won't be used instead of NSAIDS, colchicine and corticosteroids such as prednisone.But it's recommended that NSAIDs or colchicine are used along with it, at least in the early weeks of treatment.
　　In most countries it will only be used in gout patients who have chronic hyperuricemia (high UA levels) AND gout, not merely hyperuricemia.It does not work to improve uric acid excretion, so under-excretors may not benefit from it.　　
　　2.What's the dosage?
    This new gout drug is taken orally as a tablet. The recommended dosage is 40 mg-80 mg daily. If, after two weeks there is no reduction in UA levels, the dose may be increased to 80 mg - 120 mg daily, in those countries that have approved an
increase up to 120 mg - ask your doctor. In trials, as much as 240 mg daily has been taken, but this is not a recommended amount for routine treatment. Patients will need another serum (blood) UA test after two weeks treatment to find out how well it's doing.
    3.Provision
　　It also shares one of the benefits of allopurinol. Because it has to be taken just once daily, it's simpler to take and easier not to forget. The more often a drug has to be taken each day, the more likely it is that patients forget to take it.
　　Your uric acid levels will have to be high, so if you have gout but normal or slightly raised uric acid levels, it is unlikely to be prescribed. And you must have gout crystals.
　　The presence of tophi :If you have tophi, note it has been shown to have some success against tophi. This will be an additional factor in favour (favor) of a decision to prescribe it.
　　Diets :You will not need to be on a low purine diet, or any diet. Good news too is that it can be prescribed for the elderly.
　　Kidney disease: Many gout patients suffer impaired kidneys. In trials it has performed quite well with patients who have mild kidney disease and much better than allopurinol, which did not reduce UA levels in patients with mild/moderate kidney disease by as much. If you have mild to moderate kidney disease (renal impairment) your doctor can determine whether it is right for you. If your kidneys pass certain tests, you'll almost certainly get it, and you won't need a lowered dose.
　　Febuxostat is a big new plus for kidney disease patients who have gout because doctors are very wary of prescribing drugs which encourage uric acid excretion by the kidneys.But if you have severe kidney problems, it will be used with great caution, or it is not recommended.