febuxostat / Generic mfg. - LARVOL DELTA

The Effect of Febuxostat on Kidney Outcomes in Patients with Chronic Kidney Disease and Asymptomatic Hyperuricemia: A Target Trial Emulation. (PubMed, Am J Nephrol) - "In patients with stage 3-4 CKD and asymptomatic hyperuricemia, initiation of febuxostat was not associated with kidney outcomes, all-cause mortality, or MACE. Further studies are warranted to validate these findings."

Journal • Cardiovascular • Chronic Kidney Disease • Nephrology • Renal Disease

FLAG/VEN as a frontline induction therapy for AML: A multi-centre experience of Anthracycline free approach from India (ASH 2025) - "RGCIRC/IRB-BHR/04/2023 dated 4th February 2023.Induction therapy: All patients received tumor lysis syndrome prophylaxis with intravenous hydrationand Tab Febuxostat...Fludarabine 30 mg/m2 IV once daily for 4 days, Cytarabine 1500 mg/m2 IV oncedaily for 4 days...Filgrastim (biosimilar) 5 mcg/kg s/c once daily from day −1 to ANC > 500 cells/ µL...Venetoclax was given as 50 mg for day 1 and2 followed by 100 mg once daily...CBF AML patientsin CR1 at day 28 in both arms received FLAG with Gemtuzumab Ozogamicin (GO) based consolidationtherapy for 4 cycles... Our results suggests that FLAG/VEN approach can decrease induction mortality rate whichis anywhere about 20-25 % in a lower middle-income country like India. FLAG/VEN achieves high CR ratesof 93% which is comparable to FLAG/IDA/VEN approach without added toxicity in the real-world scenario.This approach needs to be tested in a randomized controlled trial to establish it as a standard therapy forAML."

Clinical • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Febrile Neutropenia • Hematological Malignancies • Infectious Disease • Leukemia • Neutropenia • Pneumonia • Respiratory Diseases • Septic Shock • Tuberculosis • TP53

Evaluation of ventoclax initiation prophylaxis and monitoring outcomes at each dose level and time point in patients with chronic lymphocytic leukemia: A real-world experience (ASH 2025) - "Background : Venetoclax (VEN)+obinutuzumab (VO) is an effective therapy for CLL/SLL requiring regularmonitoring for tumor lysis syndrome (TLS) during VEN ramp-up...Adult pts with CLL/SLL were eligible if they: (1) startedVO per-label outside of a clinical trial in 1L, or immediately after exposure in 1L to agents with differentmechanisms of action (i.e., BTKi, anti-CD20 only) of <30 days; (2) prior to VEN start, had either (i) lowphysician-determined tumor burden (TB) (i.e., all lymph nodes [LN] <5 cm and ALC <25 x 109/L), or (ii)medium physician-determined TB (i.e., any LN ≥5-<10 cm or ALC ≥25 x 109/L) with creatinine clearance≥80 mL/min; (3) had no strong CYP3A inhibitors or prophylactic rasburicase from 3 days prior to VENstart until end of VEN ramp-up; and (4) had VEN ramp-up in an outpatient setting.TB-related labs/imaging was assessed from 2 months prior to obinutuzumab initiation (i.e., index date)until VEN start...Prior to VEN ramp-up, all pts..."

Clinical • Real-world • Real-world evidence • Chronic Lymphocytic Leukemia • Diabetes • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • IGH • TP53

Efficacy and safety of urate-lowering therapies in asymptomatic hyperuricaemia: a systematic review and network meta-analysis of key clinical outcomes. (PubMed, Ann Med) - "Random-effects modelling showed that, compared to controls, Verinurad_Febuxostat (P-score = 0.82; pooled mean difference [95% CI]: -3.20 [-4.76 to -1.64]) was the most effective in reducing SUA, Febuxostat (P-score = 0.78; 1.91 [0.47 to 3.35]) was the most effective in improving eGFR, Topiroxostat (P-score = 0.96; -6.10 [-11.75 to -0.45]) was most effective in improving SBP, and Febuxostat (P-score = 0.78; 0.77 [0.61 to 0.98]) reduced the risk of CREs most effectively. The Confidence in Network Meta-Analysis (CINeMA) assessment indicated that the overall quality of evidence was low to moderate. Available evidence suggests that febuxostat not only plays a significant role in lowering SUA levels but also significantly delays the decline in eGFR and reduces the risk of CREs."

Clinical • Clinical data • Journal • Retrospective data • Review • Cardiovascular • Chronic Kidney Disease • Hepatology • Liver Failure • Metabolic Disorders • Nephrology • Renal Disease • CRP

Network pharmacology combined with ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry method to explore the mechanism of Shizhi Fang in treating uric acid nephropathy mice. (PubMed, J Tradit Chin Med) - "SZF may exert therapeutic effects on UAN through multiple targets and pathways."

IO biomarker • Journal • Preclinical • Oncology • Renal Disease • CASP3 • MMP9 • TLR4

Mechanism of xanthine oxidase in flap ischemia-reperfusion injury and advances in targeted therapy: a mini review. (PubMed, Front Physiol) - "Allopurinol and febuxostat, xanthine oxidase inhibitor, primarily exerts its protective effects by inhibiting the activity of xanthine oxidase and reducing reactive oxygen species generation, thereby suppressing oxidative stress damage. Additionally, it may improve flap survival through other mechanisms, such as modulating inflammatory responses and suppressing apoptosis. This article systematically reviews the pathological mechanisms and therapeutic advances of skin flap ischemia-reperfusion injury, with a focus on exploring the role of xanthine oxidase inhibitors in flap protection by targeting and regulating oxidative stress pathways, aiming to provide new therapeutic strategies and theoretical basis for clinical prevention and treatment of skin flap ischemia-reperfusion injury."

Journal • Review • Cardiovascular • Inflammation • Reperfusion Injury

Exploring the role of febuxostat's drug target XOR in erectile dysfunction: insights from human genetics and rat models. (PubMed, Front Med (Lausanne)) - "After 1 month of continuous oral administration of FB, XOR and MDA levels and the apoptosis rate in the corpus cavernosum were significantly reduced in hyperuricemic ED rats, while p-eNOS expression, the p-eNOS/eNOS ratio, and levels of NO and SOD were markedly increased. FB reducing oxidative stress and apoptosis in penile corpus cavernosum tissue in hyperuricemic rats by inhibiting XOR, thereby ameliorates ED."

Journal • Preclinical • Erectile Dysfunction • NOS3

Deciphering the Role of N-Acetyltransferase 10 in Thalamic Hemorrhage Through Integrative Multi-Omics and Experimental Validation. (PubMed, J Integr Neurosci) - "This study provides the first comprehensive molecular insights into the therapeutic potential of NAT10 inhibition in TH. Moreover, it identified NAT10 inhibitors and febuxostat as promising candidates for TH management, paving the way for future therapeutic development targeting NAT10 in this condition."

Journal • CNS Disorders • Hematological Disorders

Potential therapeutic targets in the prevention of testicular ischemia-reperfusion injury. (PubMed, Front Reprod Health) - "Hence, this review recommends that blocking the XO-ROS pathway with febuxostat after the onset of testicular torsion (TT), minimizing the calcium-mediated apoptotic pathway and restoring the loss of vasomotor tone with amlodipine on reperfusion, as well as blocking ROS-burst with vitamin E in the later phase of reperfusion, may help to mitigate the effect of TIRI in humans and thus prevent future infertility. Nevertheless, further research is needed to verify this claim and delineate the possible drug-drug interactions, as well as potential effects on other organs."

Journal • Review • Cardiovascular • Infertility • Inflammation • Reperfusion Injury • Sexual Disorders

Febuxostat alleviates gout-associated hyperuricemia and inflammation by downregulating IL1A to modulate TLR2/TLR4/NF-κB signaling pathway. (PubMed, Int Immunopharmacol) - "Feb treats gout by downregulating IL1A to modulate the TLR2/TLR4/NF-κB signaling pathway, making IL1A a potential biomarker for gout management and highlighting the therapeutic prospects of Feb in targeting inflammation-related pathways."

Journal • Gout • Inflammation • Inflammatory Arthritis • Rheumatology • IL18 • IL1A • IL1B • IL6 • TLR2 • TLR4 • TNFA

Febuxostat effectively and safely reduces serum urate in gout patients with chronic kidney disease: A prospective multicenter ULTRA registry study. (PubMed, J Rheumatol) - "Therefore, an individualized dosing strategy based on SU response, rather than renal function alone, may optimize treatment outcomes in these patients."

Journal • Chronic Kidney Disease • Gout • Immunology • Inflammatory Arthritis • Nephrology • Renal Disease • Rheumatology

Correlation between Blood Uric Acid Fluctuation and Prognosis in Patients with Chronic Kidney Disease Combined with Hyperuricemia: A Multicenter Real-World Study. (PubMed, Kidney Dis (Basel)) - "(2) In the northeastern population of China and among patients treated with sodium bicarbonate, greater SUA fluctuations are associated with higher all-cause mortality risk. During the 24-month follow-up period, the risk of MACE results due to SUA fluctuations was not significantly associated with the population; SUA fluctuations in populations with tumors, diabetes, hyperkalemia, metabolic acidosis, gender, and those treated with febuxostat do not show a significant link to all-cause mortality risk."

Journal • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Diabetes • Ischemic stroke • Metabolic Disorders • Myocardial Infarction • Nephrology • Oncology • Renal Disease • CRP

Cardiovascular morbidity and mortality in gout: is gout an Independent risk Factor? (PubMed, Expert Opin Pharmacother) - "Colchicine use is associated with reduced acute CV events both in general population with CAD and in gout. Treat-to-target (T2T) serum urate approach entails titrating ULT by monitoring serum urate levels and gout flares. Allopurinol, the most commonly used and inexpensive ULT, in approved daily doses of 300-800 mg can achieve target serum urate less than 6 mg/dl or 5 mg/dl."

Journal • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Gout • Immunology • Inflammation • Inflammatory Arthritis • Metabolic Disorders • Myocardial Infarction • Rheumatology

Febuxostat Versus Allopurinol Use in Gout Patients: A Real-World Study. (PubMed, Cureus) - "While the febuxostat group showed more events, this was associated with a higher prevalence of almost all risk factors. Interpreting study results and applying them practically remain difficult given the constellation's commonality in clinical life; therefore, careful consideration is necessary."

Journal • Real-world evidence • Cardiovascular • Gout • Inflammatory Arthritis • Rheumatology

Novel Isoidide Subunit-Containing Xanthine Oxidase Inhibitors with Potent Hypouricemic Effects. (PubMed, J Med Chem) - "Here, a novel series of isoidide subunit-containing XO inhibitors was developed through structural optimization of febuxostat...Furthermore, Z29 showed no toxicity to vascular cells in vitro and demonstrated a favorable safety profile in in vivo evaluations of acute toxicity and cardiotoxicity. These findings highlight Z29 as a promising therapeutic candidate for hyperuricemia and gout."

Journal • Cardiovascular • Gout • Inflammatory Arthritis • Rheumatology

Effectiveness and Safety of the Novel Selective Urate Reabsorption Inhibitor Dotinurad After Switching from Febuxostat in Patients with Stage B/C Heart Failure. (PubMed, Drugs Real World Outcomes) - "Switching from febuxostat to dotinurad may be effective and safe over the short term in patients with Stage B/C heart failure and hyperuricemia."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Gout • Heart Failure • Inflammatory Arthritis • Nephrology • Renal Calculi • Renal Disease • Rheumatology • Urolithiasis

Disruption of Proteoglycan 4 (PRG4)-CD44 Signaling Modulates Chronic Synovitis in Conditionally Inactivated Mice. (PubMed, Res Sq) - "Methods Prg4 FrtloxP/FrtloxP are transgenic mice wherein tamoxifen (TAM) inactivates the Frt allele and creates a knockout state ( Prg4 FrtKO/FrtKO )...Febuxostat reduced CD14 + cell activation from medial ( p < 0.0001 ) and lateral ( p < 0.05 ) joint compartments...Dysfunction in PRG4 signaling, demonstrated by lower tissue levels of PRG4 along with higher CD44, XO and HIF-1α, was associated with high-grade synovitis. Targeting the downstream events of PRG4 loss is potentially therapeutic in OA synovitis."

Journal • Preclinical • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology • CD14 • HIF1A • IFNG • PRG4

Evaluating the Impact of Febuxostat on 5-Aminolevulinic Acid-Based Photodynamic Therapy in Bladder Cancer Cell Lines. (PubMed, Photodiagnosis Photodyn Ther) - "These results indicate that Febuxostat effectively potentiates the photodynamic effects of ALA in bladder cancer cells, promising a novel therapeutic strategy that warrants further exploration in preclinical models and potential clinical trials."

IO biomarker • Journal • Preclinical • Bladder Cancer • Genito-urinary Cancer • Oncology • Solid Tumor • BAX • BCL2 • CDH1 • CDH2 • HIF1A • VEGFC

Allopurinol Versus Febuxostat Use and the Risk of Cardiovascular Disease in People With Chronic Kidney Disease: A New-User Active Comparator Cohort Study. (PubMed, Nephrology (Carlton)) - "In conclusion, no statistically significant difference in the risk of cardiovascular events was observed in people with chronic kidney disease who were newly prescribed febuxostat compared with those newly treated with allopurinol."

Clinical • Journal • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Myocardial Infarction • Nephrology • Renal Disease

Dissolution Profile of Ionizable Drugs in Biorelevant Bicarbonate Buffer at Intermediate Gastrointestinal pH Level. (PubMed, AAPS J) - "For the dissolution tests, febuxostat (FBX), dipyridamole (DPM), dantrolene Na (DNT Na), pioglitazone HCl (PIO HCl), and tosufloxacin tosylate monohydrate (TFLX TS) were employed. The dissolution profiles of ionizable drugs in BCB differed from those in CPB and ACB, especially in the case of the salt-form drugs with an acidic counterion. The floating lid method enables dissolution testing using BCB in the intermediate pH range."

Journal

Response to allopurinol and febuxostat according to the fractional excretion of urate in men with gout. (PubMed, Arthritis Care Res (Hoboken)) - "Allopurinol is more effective in patients with low FEUA, probably because of the reduced renal excretion of oxypurinol. These data highlight the similarity between the renal handling of oxypurinol and urate."

Journal • Gout • Inflammatory Arthritis • Rheumatology

Febuxostat may decrease the incidence of COVID-19 infection among patients with gout: a retrospective cohort study. (PubMed, Front Pharmacol) - "After exclusion and propensity score matching, 5,466 patients with Febuxostat and 5,466 patients with Allopurinol in the comparison group were selected. In addition, Febuxostat markedly reduced the hospitalization (HR = 0.652 [0.485-0.877]) in gout patients due to renal impairment or with tophus and the risks of COVID-19 incidence (HR = 0.878 [0.801-0.963]). In this retrospective cohort study, Febuxostat use was associated with a lower risk of COVID-19 among patients with gout for 3 years follow-up, even with renal impairment or tophus."

Journal • Retrospective data • Gout • Infectious Disease • Inflammatory Arthritis • Novel Coronavirus Disease • Renal Disease • Rheumatology

Atypical Recurrence of Adenine Phosphoribosyltransferase Deficiency-Associated Nephropathy After Kidney Transplant: A Case Report (KIDNEY WEEK 2025) - "He received a living-donor kidney from his parentral aunt and was started on Anti-Thymocyte Globulin (ATG), tacrolimus, mycophenolate mofetil and prednisone...After APRT deficiency was confirmed, febuxostat (80 mg/day) was started...This case raises awareness about APRT deficiency-associated nephropathy as a potential cause of early graft dysfunction post-transplant. Misdiagnosis as rejection can lead to inappropriate treatment."

Case report • Clinical • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Calculi • Renal Disease • Transplantation

Associations of Plasma Ceramides with Adipose Tissue, Plasma, and Urinary Markers of Inflammation and Oxidative Stress in CKD (KIDNEY WEEK 2025) - P=N/A | "Methods We used stored samples and data from RCT (NCT01350388) that examined the role of uric acid lowering with febuxostat on adipokines in CKD...Table 1. Characteristics"

Oxidative stress • Cardiovascular • Chronic Kidney Disease • Inflammation • Nephrology • Obesity • Renal Disease • IL6 • TNFA

Xor Risk Variants Predispose Mice to Fructose-Mediated Metabolic Dysfunction-Induced Kidney Injury (KIDNEY WEEK 2025) - "Methods We grouped B6 and B6 Xor em1 mice as normal water controls or to receive 30% fructose water, with/without the XOR inhibitor, febuxostat, for 6 months...Xor blockade improved this phenotype, supporting the role of Xor activity in predisposition to kidney injury by fructose. Conclusion Xor risk variants predispose to severe tubular injury induced by fructose-mediated -metabolic dysfunction by influencing pathways involved in de novo lipogenesis which can lead to lipid accumulation and oxidative stress."

Preclinical • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus