In February, the Food and Drug Administration issued a boxed warning for the gout treatment febuxostat (Uloric, Takeda) citing a risk for cardiovascular disease. It was approved in 2009 for adult patients with gout.
“Febuxostat is no longer recommended as a co-first line treatment (along with the first line choice allopurinol) for urate-lowering in gout,” said Robert Terkeltaub M.D., the rheumatology section chief of the VA Medical Center in San Diego and the corresponding author of the 2012 ACR gout guidelines. “This is as a result of the CARES trial, and an associated FDA warning regarding relative cardiovascular mortality risk of febuxostat compared to allopurinol.”
In this slideshow, we focus on the guidelines, 2012 American College of Rheumatology Guidelines for Management of Gout Part 1: Systematic Nonpharmacologic and Pharmacologic Therapeutic Approaches to Hyperuricemia, which otherwise remain unchanged.