The effectiveness of benzbromarone versus febuxostat in gouty patients: a retrospective study

Abstract Background Benzbromarone and febuxostat have different mechanisms in reducing serum urate. Nevertheless, the effectiveness of benzbromarone versus febuxostat in reducing serum urate in gouty patients classified with different types of hyperuricemia remain unclear.Methods In this retrospective study from January 1, 2018 to September 30, 2020, subjects were retrieved if they were newly treated with benzbromarone 25mg daily or febuxostat 20mg daily with 24-hour urinary uric acid and 24-hour urinary creatinine measured. Baseline data and follow-up information after 28 ± 3 days treatment were collected from medical records. Subjects were classified into four types according to their 24-hour urinary uric acid and fractional excretion of uric acid.Results A total of 73 subjects with gout were finally enrolled. Among them, 50 were treated with benzbromarone. The percent changes in serum urate from the baseline were -33.71 ± 13.59% in benzbromarone group and -29.45 ± 10.62% in febuxostat group without significant difference between the two groups (P = 0.188). In subgroup analysis, no differences were found between the two groups among subjects classified as renal underexcretion, the combined type, or “normal” type. In patients with eGFR ≥ 70 mL/min/1.73m2, the rate of serum urate lowering was higher in those treated with benzbromarone than febuxostat. Renal function did not change significantly from the baseline for both drugs.Conclusion Benzbromarone 25mg daily and febuxostat 20mg daily had comparable effectiveness in lowering serum urate among different types of hyperuricemia. Benzbromarone was more effective than febuxostat in lowering serum urate in subjects with eGFR ≥ 70 mL/min/1.73m2.