Oleh Admin Kalbe Medical pada April 05, 2013 07:24

Perbandingan Febuxostat dengan Allopurinol untuk Terapi Gout

Sebuah analisis retroprospektif terhadap 222 wanita pengidap gout, yang membandingkan febuxostat dengan allopurinol, menunjukkan bahwa febuxostat 80 mg/hari lebih efektif dibanding allopurinol 100, 200, atau 300 mg/hari untuk menurunkan kadar asam urat di bawah 6 mg/dL.

Studi retroprospektif lain, yang dilakukan oleh dr. Saima Chohan dan kolega dari University of Chicago Pritzker School of Medicine dan Takeda Global Research & Development, membandingkan keefektifan febuxostat, allopurinol, dan plasebo pada terapi gout. Data studi ini mencakup 4.101 pasien, 226 di antaranya adalah wanita. Empat  pasien dengan nilai awal kadar asam urat di bawah 8 mg/dL dikeluarkan dari studi.

Dibandingkan dengan pasien pria pada studi yang sama, pasien wanita lebih tua (rata-rata usia 62 tahun vs 52 tahun), lebih berat (rata-rata indeks massa tubuh 36 vs 33 kg/m2), dan lebih sedikit yang mengonsumsi alkohol (37,6% vs 69%). Pasien wanita juga lebih lama menderita gout (12 vs 8 tahun) dan memiliki kecenderungan yang lebih untuk menderita hipertensi, diabetes, hiperlipidemia, obesitas, dan gangguan ginjal.

Dosis febuxostat yang diberikan adalah 40, 80, 120, atau 240 mg/hari. Dosis allopurinol adalah 100, 200, atau 300 mg/hari, bergantung pada fungsi ginjal. Proporsi pasien wanita yang mencapai kadar asam urat <6 mg/dL pada kunjungan terakhir lebih besar pada kelompok febuxostat dibandingkan dengan kelompok allopurinol. Efikasi penurunan kadar asam urat febuxostat 80 mg atau 120 mg secara signifikan lebih baik dibandingkan dengan allopurinol (p <0,001 dan p <0,006).

Peneliti menduga bahwa febuxostat 80, 120, atau 240 mg/hari memiliki efikasi penurunan asam urat yang lebih baik dibanding dengan allopurinol pada pasien wanita dengan gangguan ginjal derajat ringan – sedang, dan febuxostat 50 mg/hari sama efektifnya pada pasien wanita dengan gangguan ginjal ringan (tetapi tidak pada mereka dengan gangguan ginjal yang lebih serius).

Efek samping pada pasien wanita sebanding dengan kelompok pasien secara keseluruhan. Sekalipun pasien wanita dengan gout cenderung memiliki gangguan kardiovaskuler, metabolik, dan ginjal, terapi penurunan asam urat dengan febuxostat dan allopurinol secara umum relatif aman. 

Simpulannya, febuxostat 80 mg/hari dan 120 mg/hari menurunkan asam urat lebih baik dibandingkan dengan allopurinol 100 – 300 mg/hari pada pasien wanita pengidap gout, dan keduanya relatif aman. Namun, belum terdapat perbandingan antara febuxostat dengan allopurinol dengan dosis yang lebih tinggi (600 mg/hari). (YYA)




Image: Ilustrasi

Reference:
1. Kelly JC. Febuxostat better than allopurinol for women with gout. Medscape medical news. Available from: http://www.medscape.com/viewarticle/755607
2. Chohan S, Becker MA, MacDonald PA, Chefo S, Jackson RL. Women with gout: The efficacy and safety of urate-lowering with febuxostat and allopurinol. Arthritis Care Res. 2011.

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