Response to Allopurinol and Febuxostat According to the Fractional Excretion of Urate in Men With Gout
Authors' conclusion
Allopurinol is more effective in patients with low FEUA, probably because of the reduced renal excretion of oxypurinol.
Study context
- Population
- Men with gout starting allopurinol or febuxostatoxypurinol subgroup n = 181 · Men with gout starting allopurinol 1,547 · or febuxostat 296
- Exposure
- Fractional excretion of uric acid (FEUA) ≤5.5% vs >5.5% in urate-lowering response to allopurinol
- Outcome
- Change in serum urate per 150-mg increase in allopurinol according to FEUA
Methodological detailslinear mixed-effects regression adjusted for body mass index (BMI), estimated GFR (eGFR) and treatment doses
- Linear mixed-effects regression adjusted for BMI, eGFR and treatment doses
Main finding
As reported in the abstract
Change in serum urate per 150-mg allopurinol increase
FEUA ≤5.5%
−72.37
CI −74.81–-69.94 · μM
FEUA >5.5%
−65.96
CI −71.29–-60.62 · μM
P = 0.032
Observational data: associations, not effects.
Further findings
Median FEUA, whole population
- Median FEUA 4.0% (quartile 1-3: 3%-5.1%)
Oxypurinol concentrations
- Higher oxypurinol concentrations in patients with the lowest FEUA
- P = 0.032
Febuxostat response by FEUA
- No interaction between febuxostat response and FEUA
- P = 0.13
Original publication
Response to Allopurinol and Febuxostat According to the Fractional Excretion of Urate in Men With Gout. Arthritis Care Res (Hoboken). Published 24 January 2026. doi:10.
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