Gout is a common and painful rheumatologic disorder affecting 1 to 2 percent of adults in developed countries. Allopurinol remains the most commonly prescribed agent for gout in the United States. Unfortunately, many patients treated with allopurinol do not achieve target serum uric acid (sUA) levels, possibly due to the need for dosage adjustment in patients with renal insufficiency and the perceived intolerability to allopurinol in doses greater than 300 mg per day. Febuxostat, an oral non-purine inhibitor of xanthine oxidase, was recently approved by the US Food and Drug Administration for chronic management of hyperuricemia in patients with gout. The purpose of this manuscript is to review the data with febuxostat compared with allopurinol and to discuss their relative place in therapy.
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