Valmiki Sai Kiran¹*, Chinthaginjala Harish¹, Padwal Shradda¹, B Swathi², R Sandhya², YSN Murthy³ and Guruprasad⁴

¹Department of Pharm. D, Bharat School of Pharmacy, Mangalpally, Ibrahimpatnam, Hyderabad, India
²Assistant Professor, Bharat School of Pharmacy, Mangalpally, Ibrahimpatnam, Hyderabad, India
³Medical Director, MS Senior Consultant Orthopaedic, Department of Orthopaedics, Durgabai Deshmukh Hospital and Research Centre (AMS), Vidyanagar, Hyderabad, India
⁴Consultant Orthopaedic, Department of Orthopaedics, Durgabai Deshmukh Hospital and Research Centre (AMS), Vidyanagar, Hyderabad, India

*Corresponding Author: Valmiki Sai Kiran, Chinthaginjala Harish and Padwal Shradda; Department of Pharm. D, Bharat School of Pharmacy, Mangalpally, Ibrahimpatnam, Hyderabad, India.

Received: August 24, 2022; Published: September 30, 2022

Abstract

Objective: To Evaluate the comparative study of safety and Efficacy of Allopurinol and Febuxostat in patients with hyperuricemia. To report adverse effects of allopurinol and febuxostat. Evaluation of Laboratory investigations by Serum Uric Acid Test.

Introduction: Hyperuricemia is defined by a rise in serum urate levels > 7.0mg/Dl. It is caused by a combination of a factors including nutrition, genetic predisposition and urate overproduction or underproduction. Uric acid is a by-product of protein metabolism. Allopurinol and Febuxostat is used to treat hyperuricemia patients (chronic gout) with a dose of 100-300 mg and 40-80 mg respectively.

Methodology: Out of 200 patients with hyperuricemia were randomly assigned to allopurinol group (100) and febuxostat group (100) in that both males and females are equally randomized. The Duration of the study is 6 months and was designed as a prospective, comparative, observational and follow-up component. This study was carried out in patients suffering from hyperuricemia to evaluate the comparative study of safety and efficacy of Allopurinol and Febuxostat in the Department of Orthopaedics, Durgabai Deshmukh Hospital, 300 bedded multi-speciality hospital from January 2021. All statistical analysis are performed by using IBM SPSS windows V24. Descriptive statistics like mean, SD, are calculated for Age, height, weight, BMI, serum uric acid. ANCOVA was performed to compare mean values of uric acid. X2- test were used to study the association between the BMI category and drugs.

Results: We found no statistically significant correlation between age, height, weight, or BMI and drugs in our study. Using the x2-test, we found no correlation between BMI category and drug in our study. In both groups, when gender is considered, there is a statistically significant difference between age and drugs for female patients, but not for male patients. Out of 200 patients in our study, 116 patients (61 men and 55 women) had adverse effects that were reported, and 84 patients (39 men and 45 women) had no adverse effects. Compared to other drugs allopurinol has more side effects.

Conclusion: In our study, it is proved that febuxostat with a dose 40-80mg/day is shown to be be more efficacious and safer in reducing serum urate concentration than allopurinol 100-300mg/day. Allopurinol shows a major adverse effect as compared to febuxostat.

Keywords: Hyperuricemia; Uric Acid; Protein Metabolism; Xanthine Oxidase

References

1. James E., et al. “Gout and Hyperuricemia chapter 19”. In: Eric T. Herfindal, Dick R. Gourley, Linda Lyoyd Hart, Clinical pharmacy and Therapeutics, 4^th Edition Wolters Kluwer (India), Lippincott Williams and Wilkins (1992): 331.
2. Bohan KH. Gout and Hyperuricemia. ln: Alldredge BK, Corelli RL, Ernst ME et. al. “Koda-kimble and Yong's Applied Therapeutics The clinical use of drugs”. 10^th Philadelphia: wolters Klower/Lippincott Williams and Wilkins (2013): 1161.
3. Kumar B and Agarwal PK. “Comparative evaluation of efficacy and safety profile of febuxostat with allopurinol in patients with hyperuricemia and gout”. International Journal of Pharma Medicine and Biological Sciences 4 (2013): 52-56.
4. Ernst M., et al. Gout and Hyperuricemia. ln: Dipiro J, Tabert R et al. “Pharmacotherapy A Pathophysiological Approach”. 7^th New York: Mc Graw Hill (2008): 1539-1550.
5. Becker MA., et al. “Febuxostat compared with allopurinol in patients with Hyperuricemia and gout”. New England Journal of Medicine23 (2005): 2450-2461.
6. Borne R., et al. Nonsteroidal Anti-inflammatory Drugs. ln: williams D, Lemke T, Roche V, Zito W, Foye W. “Foye's Principles of Medicinal Chemistry”. 6^th Philadelphia: Lippincott Williams and Wilkins/Wolfers klower (2008): 954-1003.
7. Sezai A., et al. “Comparison of febuxostat and allopurinol for hyperuricemia in cardiac surgery patients (NU-FLASH Trail)”. Circulation Journal (2013): CJ-13.
8. Grosser T., et al. “Anti-inflammatory, Anti pyretic and Analgesic agents, Pharmacotherapy of Gout. In: Brunton L. “Goodman and Gilman's The pharmacological basis of Therapeutics”. 12^th Newyork: Mc Graw Hill (2011): 959-1004.
9. Hawkins T and Cunnington A. “Gout and Hyperuricemia. ln: Walker R, Whittlesea C. “Clinical pharmacy and Therapeutics”. 5^th Edinburgh: Churchill Livingston/Elsevier (2012): 848-860.
10. Shen X., et al. “Comparison of efficacy and safety between febuxostat and allopurinol in early post‐renal transplant recipients with new onset of hyperuricemia”. Journal of Clinical Pharmacy and Therapeutics2 (2019): 318-326.
11. Huang X., et al. “An allopurinol-controlled, multicenter, randomized, double-blind, parallel between- gruop, comparative study of fubexostat in Chinese patients with gout and hyperuricemia”. International Journal If Rheumatic Diseases6 (2014): 679-686.
12. Andrejus Korolkovas. Drugs for Metabolism and Nutrition. “Essentials of Medicinal Chemistry”. 2^nd Edition 926.

Citation

Citation: Valmiki Sai Kiran, Chinthaginjala Harish and Padwal Shradda., et al. “A Comparative Study of Safety and Efficacy of Allopurinol and Febuxostat in Patients with Hyperuricemia".Acta Scientific Orthopaedics 5.10 (2022): 165-171.

Copyright

Copyright: © 2022 Valmiki Sai Kiran, Chinthaginjala Harish and Padwal Shradda., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.