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https://www.readbyqxmd.com/read/28089200/limitations-of-the-current-standards-of-care-for-treating-gout-and-crystal-deposition-in-the-primary-care-setting-a-review
#1
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
January 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28079821/febuxostat-induced-agranulocytosis-in-an-end-stage-renal-disease-patient-a-case-report
#2
Xue Er Poh, Chien-Te Lee, Sung-Nan Pei
INTRODUCTION: Febuxostat, a nonpurine xanthine oxidase inhibitor, is approved as the first-line urate-lowering therapy in gout patients with normal renal function or mild to moderate renal impairment. The most common adverse effects of febuxostat are liver function test abnormalities, diarrhea, and skin rash. However, there is insufficient data in patients with severe renal impairment and end-stage renal disease (ESRD). We report the first case, to our knowledge, in which agranulocytosis developed after febuxostat treatment in an ESRD patient...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28074640/evaluation-of-pharmacokinetic-interactions-between-lesinurad-a-new-selective-urate-reabsorption-inhibitor-and-commonly-used-drugs-for-gout-treatment
#3
Zancong Shen, Kathy Tieu, David Wilson, Gail Bucci, Michael Gillen, Caroline Lee, Bradley Kerr
Lesinurad is a novel selective uric acid reabsorption inhibitor approved for treatment of hyperuricemia associated with gout in combination with xanthine oxidase inhibitors (XOIs). Open-label pharmacokinetic studies were performed in volunteers or subjects with hyperuricemia (serum uric acid ≥ 8 mg/dL) to investigate interactions of lesinurad (with and without concurrent XOIs) with colchicine and 2 nonsteroidal anti-inflammatory drugs: naproxen and indomethacin. Colchicine studies included consecutive 7-day treatment periods of (1) allopurinol 300 mg, allopurinol 300 mg plus lesinurad 400 or 600 mg, and continued lesinurad 400 or 600 mg; or (2) febuxostat 40 or 80 mg, febuxostat 40 or 80 mg plus lesinurad 400 mg, and continued febuxostat 40 or 80 mg plus lesinurad 600 mg...
January 11, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28057946/ismp-adverse-drug-reactions-sildenafil-induced-erythema-multiforme-acute-liver-injury-due-to-febuxostat-intravenous-acetaminophen-induced-acute-hepatotoxicity-acute-transient-myopia-induced-by-zanamivir-lidocaine-induced-hoigne-syndrome
#4
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27980008/the-pharmacodynamics-pharmacokinetics-and-safety-of-arhalofenate-in-combination-with-febuxostat-when-treating-hyperuricemia-associated-with-gout
#5
Alexandra S Steinberg, Bradley D Vince, Yun-Jung Choi, Robert L Martin, Charles A McWherter, Pol F Boudes
OBJECTIVE: Arhalofenate (ARH), in development for gout, has uricosuric and anti-flare activities. ARH plus febuxostat (FBX) were evaluated in subjects with gout for serum uric acid (SUA) lowering, drug interaction, and safety. METHODS: Open phase II trial in gout volunteers (NCT02252835). Cohort 1 received ARH 600 mg for 2 weeks, followed by sequential 1-week co-administration of FBX 80 mg followed by 40 mg. FBX 40 mg was continued alone for 2 weeks. Cohort 2 received ARH 800 mg for 2 weeks, followed by sequential 1-week co-administration of FBX 40 mg followed by 80 mg...
December 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27971596/incidence-of-febuxostat-and-allopurinol-induced-cutaneous-adverse-reaction-a-hospital-based-cohort-study
#6
C J Chang, C Chen, Y J Lin, W Chung
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27971462/the-clinical-and-pharmacoeconomic-value-of-febuxostat-for-the-treatment-of-persistent-hyperuricaemia-a-systematic-literature-review
#7
S Maistreli, G Kourlaba, C Tzanetakos, P Trontzas, N Maniadakis
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27955822/febuxostat-associated-eosinophilic-polymyositis-in-marginal-zone-lymphoma
#8
Georges Chahine, Khalil Saleh, Claude Ghorra, Nathalie Khoury, Nadine Khalife, Fouad Fayad
Febuxostat is an orally administered selective inhibitor of xanthine oxidase approved for the treatment of gout and prevention of tumor lysis syndrome. It is a relatively safe medication. Hypersensitivity reactions associated with the use of febuxostat are quite rare with only one reported case of DRESS syndrome. Recently, two case reports of rhabdomyolysis following the initiation of febuxostat were published. We hereby present the first case of rhabdomyolysis with hypereosinophilia following the administration of febuxostat to a 50-year-old patient newly diagnosed with marginal zone lymphoma...
December 7, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27936522/a-study-comparing-the-safety-and-efficacy-of-febuxostat-allopurinol-and-benzbromarone-in-chinese-gout-patients-a-retrospective-cohort-study%C3%A2
#9
Qiao Zhou, Jiang Su, Ting Zhou, Juan Tian, Xixi Chen, Jing Zhu
OBJECTIVE: To evaluate and compare the safety and efficacy of three urate lowering agents: febuxostat, allopurinol, and benzbromarone, when used to treat Chinese gout patients. METHODS: A total of 120 patients treated in our department from November 2011 to December 2014 were randomly selected and divided into four groups: febuxostat (40 mg per day), febuxostat (80 mg per day), allopurinol (100 mg, 3 × per day) or benzbromarone (50 mg per day), (n = 30 patients/group)...
December 12, 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27916277/the-cost-effectiveness-of-hla-b-5801-screening-to-guide-initial-urate-lowering-therapy-for-gout-in-the-united-states
#10
Eric Jutkowitz, Maureen Dubreuil, Na Lu, Karen M Kuntz, Hyon K Choi
OBJECTIVE: Positive HLA-B*5801 carriers are at greater risk of experiencing rare but severe allopurinol hypersensitivity syndrome (AHS) [i.e., Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)]; however, HLA-B*5801 prevalence and AHS risk vary by race/ethnicity. We evaluated the cost-effectiveness of HLA-B*5801 testing according to race/ethnicity in the United States. METHODS: We determined the cost-effectiveness of universal testing for HLA-B*5801 compared to no testing prior to the initiation of allopurinol per US major race/ethnicity groups...
November 1, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27878622/effects-of-febuxostat-on-insulin-resistance-and-expression-of-high-sensitivity-c-reactive-protein-in-patients-with-primary-gout
#11
Juan Meng, Yanchun Li, Xiaoxu Yuan, Yuewu Lu
We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)...
November 23, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27865966/febuxostat-attenuates-paroxysmal-atrial-fibrillation-induced-regional-endothelial-dysfunction
#12
YanGuang Li, FuKun Chen, Long Deng, Kun Lin, Xiangmin Shi, Shan Zhaoliang, YuTang Wang
BACKGROUND: Paroxysmal atrial fibrillation (PAF) can increase thrombogenesis risk, especially in the left atrium (LA). The exact mechanism is still unclear. OBJECTIVE: We assessed the effects of PAF on endothelial function, and investigated if febuxostat (FX) can attenuate endothelial dysfunction by inhibition of xanthine oxidase (XO). MATERIALS AND METHODS: Eighteen male New Zealand white rabbits were divided randomly into sham-operated (S), PAF (P) or FX+pacing (FP) groups...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27853065/comparison-of-the-renoprotective-effect-of-febuxostat-for-the-treatment-of-hyperuricemia-between-patients-with-and-without-type-2-diabetes-mellitus-a-retrospective-observational-study
#13
Hiroyuki Ito, Shinichi Antoku, Mariko Abe, Takashi Omoto, Masahiro Shinozaki, Shinya Nishio, Mizuo Mifune, Michiko Togane, Masaya Nakata, Tatsuya Yamashita
Objective The effects of febuxostat therapy on hyperuricemia in patients with and without type 2 diabetes were compared in this retrospective observational study after pair-matching using the propensity scores. Methods In total, 160 patients with hyperuricemia were studied as the treated set, and the 155 subjects in whom the administration of febuxostat was not discontinued during the observation period were investigated in the full analysis. The study subjects were divided into two groups based on the style of initiation of febuxostat: initial and switching therapy from allopurinol administration...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27852432/febuxostat-hypersensitivity-another-cause-of-dress-syndrome-in-chronic-kidney-disease
#14
E Paschou, E Gavriilaki, G Papaioannou, A Tsompanakou, A Kalaitzoglou, N Sabanis
Febuxostat is a xanthine oxidase inhibitor that during the last years has successfully replaced allopurinol treatment in patients with chronic kidney disease (CKD) and hyperuricemia. Several adverse events have been observed during therapy with febuxostat. DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome induced by febuxostat has been poorly described, mainly in patient with CKD who previously developed allopurinol hypersensitivity syndrome. DRESS syndrome is characterized by manifold cutaneous reactions and systemic disorders with potential devastating consequences...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27825577/efficacy-and-safety-of-febuxostat-in-73-gouty-patients-with-stage-4-5-chronic-kidney-disease-a-retrospective-study-of-10-centers
#15
Pierre-Antoine Juge, Marie-Elise Truchetet, Evangeline Pillebout, Sébastien Ottaviani, Cécile Vigneau, Clotilde Loustau, Divi Cornec, Tristan Pascart, Renaud Snanoudj, Florian Bailly, Emilie Cornec-Le Gall, Thierry Schaeverbeke, Alain Saraux, Philippe Dieudé, René-Marc Flipo, Pascal Richette, Frédéric Lioté, Thomas Bardin, Gérard Chalès, Hang-Korng Ea
OBJECTIVES: The allopurinol dose is limited in chronic kidney disease, particularly stage 4/5 chronic kidney disease. Febuxostat has a hepatic metabolism and has been approved without dose adaptation in gouty patients with stage 1-3 chronic kidney disease. We aimed to study the safety and efficacy of febuxostat for stage 4/5 chronic kidney disease. METHODS: In this retrospective study, we included patients with (1) a diagnosis of gout, (2) febuxostat treatment, (3) estimated glomerular filtration rate≤30mL/min/1...
November 4, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27815397/new-strategy-that-delays-progression-of-amyotrophic-lateral-sclerosis-in-g1h-g93a-transgenic-mice-oral-administration-of-xanthine-oxidoreductase-inhibitors-that-are-not-substrates-for-the-purine-salvage-pathway
#16
Shinsuke Kato, Masako Kato, Teruo Kusano, Takeshi Nishino
Amyotrophic lateral sclerosis (ALS), Lou Gehrig's disease, is a progressive fatal neurodegenerative disease that involves both upper and lower motor neurons. We orally administered 4 xanthine oxidoreductase (XOR) inhibitors to G1H-G93A mice carrying 25 transgene copy numbers of human mutant G93A superoxide dismutase 1, from 80 days of age. Three nonpurine-analogue inhibitors (TEI-6720: Febuxostat, Y-700 and FYX-051), but not allopurinol with a purine analogue ring (pyrazolo pyrimidine ring), significantly delayed disease onset, prolonged survival and the duration of disease stages, improved clinical signs, and alleviated weight loss...
November 4, 2016: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/27802478/management-of-gout-a-systematic-review-in-support-of-an-american-college-of-physicians-clinical-practice-guideline
#17
Paul G Shekelle, Sydne J Newberry, John D FitzGerald, Aneesa Motala, Claire E O'Hanlon, Abdul Tariq, Adeyemi Okunogbe, Dan Han, Roberta Shanman
Background: Gout is a common type of inflammatory arthritis in patients seen by primary care physicians. Purpose: To review evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. Data Sources: Multiple electronic databases from January 2010 to March 2016, reference mining, and pharmaceutical manufacturers. Study Selection: Studies of drugs approved by the U...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27798726/genomic-sequencing-of-uric-acid-metabolizing-and-clearing-genes-in-relationship-to-xanthine-oxidase-inhibitor-dose
#18
Matthew B Carroll, Derek M Smith, Thomas L Shaak
It remains unclear why the dose of xanthine oxidase inhibitors (XOI) allopurinol or febuxostat varies among patients though they reach similar serum uric acid (SUA) goal. We pursued genomic sequencing of XOI metabolism and clearance genes to identify single-nucleotide polymorphisms (SNPs) relate to differences in XOI dose. Subjects with a diagnosis of Gout based on the 1977 American College of Rheumatology Classification Criteria for the disorder, who were on stable doses of a XOI, and who were at their goal SUA level, were enrolled...
October 31, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27798228/xanthine-oxidoreductase-and-its-inhibitors-relevance-for-gout
#19
REVIEW
Richard O Day, Bishoy Kamel, Diluk R W Kannangara, Kenneth M Williams, Garry G Graham
Xanthine oxidoreductase (XOR) is the rate-limiting enzyme in purine catabolism and converts hypoxanthine to xanthine, and xanthine into uric acid. When concentrations of uric acid exceed its biochemical saturation point, crystals of uric acid, in the form of monosodium urate, emerge and can predispose an individual to gout, the commonest form of inflammatory arthritis in men aged over 40 years. XOR inhibitors are primarily used in the treatment of gout, reducing the formation of uric acid and thereby, preventing the formation of monosodium urate crystals...
December 1, 2016: Clinical Science (1979-)
https://www.readbyqxmd.com/read/27791405/experimental-and-early-investigational-drugs-for-angina-pectoris
#20
Islam Y Elgendy, David E Winchester, Carl J Pepine
Ischemic heart disease (IHD) is a major cause of death and disability among Western countries and angina pectoris is the most prevalent symptomatic manifestation. Strategies to improve management of chronic stable angina are a priority. Areas covered: A comprehensive review was conducted using the Medline and Cochrane databases as well as the clinical trial databases in the United States and Europe. Traditional therapies for angina will be discussed. This review particularly emphasizes investigational therapies for angina (including pharmacological agents, cell and gene based therapies, and herbal medications)...
December 2016: Expert Opinion on Investigational Drugs
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