The results of a major European study have shown that a newer, long-term treatment to prevent gout attacks by lowering uric acid in the blood, is as safe in gout patients with heart and circulatory (cardiovascular) problems as the older, standard treatment.

Researchers at the Universities of Dundee, Glasgow, and Edinburgh, as well as medical centres in England, Denmark and Sweden, compared the cardiovascular safety of allopurinol to the more recently introduced febuxostat in over 6,000 patients in general practice and secondary hospital care over a period of nearly ten years (2011 to 2019).

The Febuxostat versus Allopurinol Streamlined Trial (FAST) found no significant difference in the number of heart attacks, strokes, and other serious cardiovascular events or deaths, between the two gout treatments. The findings have been published in The Lancet

Allopurinol was the first urate-lowering drug for the treatment of gout and has been used as the main medication to lower uric acid levels and prevent gout attacks for over 50 years.

Febuxostat is particularly useful for treating patients with gout who are intolerant of allopurinol and patients with reduced kidney function but, because of safety concerns, is not currently recommended as a treatment for patients with pre-existing cardiovascular disease. The study authors believe that medicines regulators should now reconsider and modify their current advice to avoid the use of febuxostat in patients with cardiovascular disease.

Emeritus Professor George Nuki, one of the FAST Study’s lead researchers and a medical trustee for the UK Gout Society said: “We hope that the FAST trial results will help to reassure patients with gout, and the doctors who treat them, that febuxostat is as safe as allopurinol in patients with increased risks of cardiovascular disease.“