ArticleJournal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases2015
A Real-World Study of Switching From Allopurinol to Febuxostat in a Health Plan Database.
Article in Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Predictors of poor response to urate-lowering therapy in patients with gout and hyperuricemia: a post-hoc analysis of a multicenter randomized trial.Clinical rheumatology · 2019Trial
- Current state and prospects of gout treatment in Korea.The Korean journal of internal medicine · 2022Review
- Factors associated with achieving target serum uric acid level and occurrence of gouty arthritis: A retrospective observational study of Japanese health insurance claims data.Pharmacoepidemiology and drug safety · 2021Observational
- Investigating the Potential of Transmucosal Delivery of Febuxostat from Oral Lyophilized Tablets Loaded with a Self-Nanoemulsifying Delivery System.Pharmaceutics · 2020Article
- Comparison of renoprotective effects of febuxostat and allopurinol in hyperuricemic patients with chronic kidney disease.International urology and nephrology · 2019Article
- Accuracy of the HumaSensArthritis research & therapy · 2018Article
- Predictors of reaching a serum uric acid goal in patients with gout and treated with febuxostat.ClinicoEconomics and outcomes research : CEOR · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveThe objective of this study was to assess the real-world comparative effectiveness of continuing on allopurinol versus switching to febuxostat.
methodsIn a retrospective claims data study of enrollees in health plans affiliated with Optum, we evaluated patients from February 1, 2009, to May 31, 2012, with a gout diagnosis, a pharmacy claim for allopurinol or febuxostat, and at least 1 serum uric acid (SUA) result available during the follow-up period. Univariate and multivariable-adjusted analyses (controlling for patient demographics and clinical factors) assessed the likelihood of SUA lowering and achievement of target SUA of less than 6.0 mg/dL or less than 5.0 mg/dL in allopurinol continuers versus febuxostat switchers.
resultsThe final study population included 748 subjects who switched to febuxostat from allopurinol and 4795 continuing users of allopurinol. The most common doses of allopurinol were 300 mg/d or less in 95% of allopurinol continuers and 93% of febuxostat switchers (prior to switching); the most common dose of febuxostat was 40 mg/d, in 77% of febuxostat switchers (after switching). Compared with allopurinol continuers, febuxostat switchers had greater (1) mean preindex SUA, 8.0 mg/dL versus 6.6 mg/dL (P < 0.001); (2) likelihood of postindex SUA of less than 6.0 mg/dL, 62.2% versus 58.7% (P = 0.072); (3) likelihood of postindex SUA of less than 5.0 mg/dL, 38.9% versus 29.6% (P < 0.001); and (4) decrease in SUA, 1.8 (SD, 2.2) mg/dL versus 0.4 (SD, 1.7) mg/dL (P < 0.001). In multivariable-adjusted analyses, compared with allopurinol continuers, febuxostat switchers had significantly higher likelihood of achieving SUA of less than 6.0 mg/dL (40% higher) and SUA of less than 5.0 mg/dL (83% higher).
conclusionsIn this "real-world" setting, many patients with gout not surprisingly were not treated with maximum permitted doses of allopurinol. Patients switched to febuxostat were more likely to achieve target SUA levels than those who continued on generally stable doses of allopurinol.
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