Celebrating Versatility: Febuxostat’s Multifaceted Therapeutic Application

Author:

Kraev Krasimir Iliev1ORCID,Geneva-Popova Mariela Gencheva1ORCID,Hristov Bozhidar Krasimirov2ORCID,Uchikov Petar Angelov3,Popova-Belova Stanislava Dimitrova1,Kraeva Maria Ilieva4,Basheva-Kraeva Yordanka Mincheva56,Stoyanova Nina Staneva56,Mitkova-Hristova Vesela Todorova56

Affiliation:

1. Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria

2. Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria

3. Department of Special Surgery, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria

4. Department of Otorhynolaryngology, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria

5. Department of Ophthalmology, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria

6. University Eye Clinic, University Hospital, 4000 Plovdiv, Bulgaria

Abstract

Febuxostat, initially developed as a xanthine oxidase inhibitor to address hyperuricemia in gout patients, has evolved into a versatile therapeutic agent with multifaceted applications. This review provides a comprehensive overview of febuxostat’s mechanism of action, its effectiveness in gout management, its cardiovascular safety profile, renal and hepatic effects, musculoskeletal applications, safety considerations, and emerging research prospects. Febuxostat’s primary mechanism involves selective inhibition of xanthine oxidase, resulting in reduced uric acid production. Its pharmacokinetics require personalized dosing strategies based on individual characteristics. In gout management, febuxostat offers a compelling alternative, effectively lowering uric acid levels, relieving symptoms, and supporting long-term control, especially for patients intolerant to allopurinol. Recent studies have demonstrated its cardiovascular safety, and it exhibits minimal hepatotoxicity, making it suitable for those with liver comorbidities. Febuxostat’s potential nephroprotective effects and kidney stone prevention properties are noteworthy, particularly for gout patients with renal concerns. Beyond gout, its anti-inflammatory properties hint at applications in musculoskeletal conditions and a broader spectrum of clinical contexts, including metabolic syndrome. Emerging research explores febuxostat’s roles in cardiovascular health, neurological disorders, rheumatoid arthritis, and cancer therapy, driven by its anti-inflammatory and antioxidative properties. Future directions include personalized medicine, combination therapies, mechanistic insights, and ongoing long-term safety monitoring, collectively illuminating the promising landscape of febuxostat’s multifaceted therapeutic potential.

Publisher

MDPI AG

Subject

Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics

Reference53 articles.

1. Febuxostat: A new treatment for hyperuricaemia in gout;Edwards;Rheumatology,2009

2. 2016 updated EULAR evidence-based recommendations for the management of gout;Richette;Ann. Rheum. Dis.,2017

3. (2009). Febuxostat: New drug. Hyperuricaemia: Risk of gout attacks. Prescrire Int., 18, 63–65.

4. Gerriets, V., and Jialal, I. (2023). StatPearls, StatPearls Publishing. Available online: https://www.ncbi.nlm.nih.gov/books/NBK544239/.

5. Pharmacokinetics, pharmacodynamics and safety of febuxostat, a non-purine selective inhibitor of xanthine oxidase, in a dose escalation study in healthy subjects;Khosravan;Clin. Pharmacokinet.,2006

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