Effects of adding urinary alkalizer citrate mixture to febuxostat in gout patients with combined-type hyperuricemia and low urine pH: a prospective cohort study
Authors' conclusion
Adjunctive urine alkalization with febuxostat demonstrated a superior urate-lowering response and improved metabolic abnormalities in male with gout and combined-type hyperuricemia.
Study context
- Population
- Patients with gout, combined-type hyperuricemia and low urine pH (< 6.2), gout clinic194 completed 12 weeks
- Participants
- 234 patients
- Exposure
- Citrate mixture added to febuxostat vs febuxostat alone
- Alkalizationn = 96
- Non-alkalizationn = 98reference
- Outcome
- Achievement of SU < 360 µmol/L at final assessment
- Follow-up
- 12 weeks
Methodological detailsopen label, single gout clinic, treatment by shared decision
- Open label
- Single gout clinic
- Treatment by shared decision
Main finding
As reported in the abstract
SU < 360µmol/L achieved · week 12
P < 0.05
Observational data: associations, not effects.
Further findings
Febuxostat dose · week 12
P < 0.05
Renal urate excretion · week 12
- Significantly increased in the alkalization group
Metabolic measures
- Triglyceride concentration and triglyceride-glucose index lower, HDL cholesterol and insulin sensitivity higher in the alkalization group
Safety
Adverse events
- Incidence similar between groups
Original publication
Effects of adding urinary alkalizer citrate mixture to febuxostat in gout patients with combined-type hyperuricemia and low urine pH: a prospective cohort study. Arthritis Res Ther. Published 19 February 2026. doi:10.
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