Febuxostat : le petit nouveau dans le quartier

Febuxostat est un médicament pharmaceutique découvert pour la première fois par des scientifiques japonais en 1998, commercialisé sous le nom d'Uloric aux États-Unis et d'Adenuric en Europe. Febuxostat est arrivé sur le marché européen en 2008 et Takeda Pharmaceutical a obtenu l'approbation de la FDA pour les États-Unis en 2009. C'est un médicament qui inhibe la xanthine oxydase, réduisant ainsi efficacement l'acide urique dans le corps. Comme l'allopurinol, il est utilisé pour traiter la goutte chronique et d'hyperuricémie.

Des recherches récentes suggèrent que febuxostat est plus efficace que allopurinol dans le traitement de la goutte. Selon les auteurs d'une étude publiée dans Arthritis Research & Therapy Efficacité comparative de la réduction de l'urate avec febuxostat par rapport à l'allopurinol dans la goutte : analyses à partir d'une vaste cohorte de soins de santé gérés aux États-Unis, le traitement optimal de la goutte repose sur deux principes : l'utilisation chronique adéquate des thérapies réductrices d'urate et la recherche d'atteindre des niveaux cibles d'urate sérique (sUA) et des thérapies anti-inflammatoires pour les crises aiguës et la prophylaxie anti-inflammatoire.." Notez qu'avant l'approbation de la FDA pour Febuxostat en 2009, le seul médicament utilisé à cette fin était l'allopurinol.

Les chercheurs ont mené une étude rétrospective sur les données médicales et pharmaceutiques ainsi que les données de laboratoire d'une vaste cohorte de soins de santé commerciaux et d'assurance commerciale aux États-Unis pour une période de 3 ans entre 2009 et 2011. Le but de cette étude était "d'étudier le changement de l'urate sérique (sUA) avec le traitement à l'allopurinol par rapport à febuxostat en évaluant la proportion de patients atteignant un objectif de sUA post-index de <6,0 mg/dL pendant la période de suivi, un résultat cliniquement significatif et important pour les patients atteints de goutte

Extrait de cerise acidulée pour la goutte

En conclusion, les chercheurs ont constaté que davantage d'utilisateurs de fébuxostat ont atteint les niveaux cibles d'acide urique, et cela s'est produit plus rapidement qu'avec l'allopurinol. Jusqu'à présent, le fébuxostat est recommandé comme médicament de deuxième intention pour les personnes qui ne peuvent pas utiliser l'allopurinol car il leur cause des effets secondaires. Et pour les personnes atteintes de goutte qui souffrent également d'une maladie rénale et de taux d'acide urique très élevés, le fébuxostat est plus efficace pour régulariser les niveaux d'acide urique.

Des recherches continuent d'être menées dans le monde entier sur les effets à long terme du fébuxostat. Je vous tiendrai informé dès que de nouvelles informations seront disponibles. Assurez-vous de vous abonner à mes comptes Facebook et Twitter où je signale mes mises à jour sur la goutte.

Comment prendre du fébuxostat

Le fébuxostat est pris sous forme de comprimé avec de l'eau, une fois par jour avec ou sans nourriture. Le fébuxostat est disponible en comprimés de 80 mg et 120 mg. Votre médecin vous prescrira habituellement 80 mg par jour et n'augmentera la dose à 120 mg que si vous n'avez pas atteint les niveaux cibles d'acide urique. Le fébuxostat abaisse généralement les niveaux d'acide urique en quelques semaines.

Les effets secondaires associés au fébuxostat comprennent des nausées, des diarrhées, des douleurs articulaires, des maux de tête, une augmentation des niveaux d'enzymes hépatiques sériques et une éruption cutanée. Pour ceux qui veulent en savoir plus sur le fébuxostat, j'ai ajouté un lien vers cet article exhaustif de Medscape pour que vous puissiez le consulter. Si vous prenez du fébuxostat, j'aimerais avoir de vos nouvelles. Laissez un commentaire ci-dessous !

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    20 replies to "La goutte et le fébuxostat"

    • Partha

      Hi Spiro!

      Recently FDA added a boxed warning for febuxostat (plz see link below) of increased risk for cardiovascular death. I started with febuxostat initially but switched to allopurinol .. Now I have some side effects with allopurinol and I am scared to go back to febuxostat. Do you know any other medications that may be an alternative? I tried a few supplements and diet as well but my uric acid stays in the 7.2 – 7.8 range.. Any other suggestions to reduce Uric Acid ?


      • Spiro Koulouris

        There is nothing more to it, stick with allopurinol for a little longer, it takes sometime for your body to adjust to it in the beginning. A tip for yo is to split your allopurinol and take half in the morning and half at night, that should lower the side effects. Ask your doctor if you can do that.

    • […] it functions the same way as allopurinol by decreasing uric acid levels in the blood. Febuxostat goes by the brand name Uloric. It is metabolized by the liver, so it’s considered safe for those […]

    • Aris Poon

      I use Febuxostat since 2 years ago, the only time that I get gout is after eating a can of corned beef. It helped me alot

    • Rizal


      My name is Faozan Rizal, I am gout sufferer for at least 4 years, I downloaded your book already but as cinematographer/ cameraman, I have to deal with in location catering food so my gout diet was broke.

      I am in Berlin now and I have an attack when I am in the flight so 18 hours I am in so much pain in the plane. Here I just took Ibuprofen but it’s been 3 weeks until I meet the doctor here and he gave me febuxostat.

      I want to ask you something, is it taking febuxostat worsening the attack? next Friday is my 4th weeks and I really bored to be in pain and can not move my knee. I eat cherry and strict vegetarian and Gout diet as in you book now since 3 weeks ago but still can not help the pain until now. Have you ever felt that the pain is really like in the join then move to muscle?

      I try took cortisone once and help only a while, I forget to say that I can not bend my knees and the doctor said because of the crystals…is it true?
      I am writing you in pain…

      • Spiro Koulouris

        Hi Rizal!

        Febuxostat will only help take the edge off, lower the pain so you are more mobile but it sounds like you are suffering a lot, you will need to visit your doctor and most likely will prescribe you Colchicine to get rid of the pain and inflammation.

    • Donald

      I have been on Febuxostat for a month and a half and am in the midst of a 2 week gout attack. Prior to taking the medication, my uric acid was 8- 10 mg/dL and I had (have) TOPHI on my big toe. I have a uric acid meter at home that shows uric acid level in my blood is now below 3 mg/dL. Can you tell me why I am getting a gout attack? I thought they only occurred when uric acid was high. I am confused. Thank you.

      • Spiro Koulouris

        Good question Donald!

        You can get a gout attack if there is a wild swing in your uric acid level, which seems to be the case here but don’t take my word for it, check it out with your doctor. For example, many gout sufferers will get a gout attack when losing weight too quickly but if you suffer from tophi, that means your gout is on the extreme range. I hope you feel better Donald soon!

    • Binu P

      I started Febuxostat 80mg only 4 days back supplemented for the next 3 months with Colchicine twice daily.

      I was suffering from gout when I started it, but my gout flare up over the last 2-3 years had become more frequent to almost once in a week or two. It has always been on the feet and most often on around toe joints. Colchicine with NSAID for 3 days after onset would clear it but was told that it is important to be proactive and prevent it with a continuous dose of the Febuxostat. Creatinine levels were checked. Have to wait and see over the next couple of weeks to know if the gout attacks happen, especially after resume 3 times a week yoga.

      Does anyone know if there is one and what is the nature of
      link between border line high HBA1C and Uric acid, which has been 350-375 the last couple of time it was tested over the years.

      I am within healthy weight range, have always eaten ‘healthy’ and been ‘active’, but the HBA1C has not gotten a lot better, but was told it may be linked to gout attacks. From now on I will controlling my dessert intake to see if it helps when blood test is repeated in 3 months. I am not so much willing to make big dietary changes that would impact the family dynamics. Also hope Creatinine kidney function does not change much due to Febuxostat.

      Any further insight into my diagnosis and managing of gout attacks would help my initiative to find a long term plan.

    • Ayman

      One of the gout side effects that I have started to face recently is that even a small walk will cause pain in my foot just behind the big toe where the flare usually attacks, I am searching for a shoes or a special insole that I can use to decrease the pressure on my big toe as maybe this will help in reducing the pain, anyone got an idea on what to use and from where can I get it online please?

      • Spiro Koulouris

        Hi Ayman!

        A podiatrist should be able to guide to a custom made shoe insole for your feet!

      • Miranda

        Hello! Im pretty much the only young woman here, but i think i can help. I have had gout unknowingly since I was 23, 12 years ago. It was purportesly RA. I am getting my 1st Rheum doctor appointment next week because I have about 25 tophi all over my body, especially my hands and feet. No pain meds, all natural (like all my births). So I guess I’m in a lot of pain, lol. I can only walk in Sketchers Shape-ups around the house. Look into them! I buy them used on eBay between $20 and $45. They have wide toe boxes, about a 3 inch cushion on the sole and imitate barefoot walking too keep those toes mobile(so no joint fusion). I am a completely non-sedentary rural mom of 6 children 8-years-old and under, so VERY active. I go through a pair every 6 months and it is SO WORTH the cost! Also, the recommendations on barkingdogshoes.com have been very helpful to discover what brands worldwide carry comfortable shoes. I also use Wolky, Othofeet, and Gravity Defyers

    • Liam F.

      For me the flare ups stopped after about 3m. I was on a side dose of colcihine for a few months to help treat the flare ups

    • Liam F.

      The drug causes uric acid levels to decrease. In the first 3months or so it will cause uric to leach from your tissue, were it has been stored, when level was too high. This can cause gout flare ups. This will pass, as uric acid in tissue excreted. Probably best to persevere. Maybe see your doctor about a prophylaxis drug to treat flare ups your getting? Hope things improve Reese

    • Reese Railey

      Liam,I have been taking this for two months but it seems not working for me. The pain just transfers from one side to another. I can no longer work because of this. For How long did you take this and when did the pain and inflammation finally surpass?

    • Reese Railey

      Hi. Can i ask question.. Im with suffering gout. Almost 2mos it attacks on different body parts after each attack it transfers from one side to another.. Im taking febuxostat for 2mons. Yet nothing happen.. And im also taking diet program. Wat should i do?? Can i take steroids so i could get back to work??

      • Spiro Koulouris

        Follow your doctor’s advice, I don’t know enough about your health situation to provide you with any recommendations. Ask your doctor about steroids, it helps short term to remove the pain so you can be functional.

    • Chris

      Would you know if Febuxostat is available in South Africa? I had taken puricos (allopurinol) for 8 months with no success.

      • Spiro Koulouris

        Chris I wish I could help you but I don’t know why Febuxostat isn’t available there, best to contact the drug maker directly and ask if it’s available anywhere in South Africa. If allopurinol didn’t work, then you must inquire about Febuxostat and eat very healthy, follow my gout dietary tips.

    • Liam F.

      I take this. Very thankful for this drug; I coudn’t tolerate allopurinol. I’ve had no gout flare ups once through the initial three months of use of Febuxostat. Uric acid levels now normal.

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