Kraev Krasimir Iliev, Geneva-Popova Mariela Gencheva, Hristov Bozhidar Krasimirov, Uchikov Petar Angelov, Popova-Belova Stanislava Dimitrova, Kraeva Maria Ilieva, Basheva-Kraeva Yordanka Mincheva, Stoyanova Nina Staneva, Mitkova-Hristova Vesela Todorova
Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria.
Life (Basel). 2023 Nov 11;13(11):2199. doi: 10.3390/life13112199.
Febuxostat, initially developed as a xanthine oxidase inhibitor to address hyperuricemia in gout patients, has evolved into a versatile therapeutic agent with multifaceted applications. This review provides a comprehensive overview of febuxostat's mechanism of action, its effectiveness in gout management, its cardiovascular safety profile, renal and hepatic effects, musculoskeletal applications, safety considerations, and emerging research prospects. Febuxostat's primary mechanism involves selective inhibition of xanthine oxidase, resulting in reduced uric acid production. Its pharmacokinetics require personalized dosing strategies based on individual characteristics. In gout management, febuxostat offers a compelling alternative, effectively lowering uric acid levels, relieving symptoms, and supporting long-term control, especially for patients intolerant to allopurinol. Recent studies have demonstrated its cardiovascular safety, and it exhibits minimal hepatotoxicity, making it suitable for those with liver comorbidities. Febuxostat's potential nephroprotective effects and kidney stone prevention properties are noteworthy, particularly for gout patients with renal concerns. Beyond gout, its anti-inflammatory properties hint at applications in musculoskeletal conditions and a broader spectrum of clinical contexts, including metabolic syndrome. Emerging research explores febuxostat's roles in cardiovascular health, neurological disorders, rheumatoid arthritis, and cancer therapy, driven by its anti-inflammatory and antioxidative properties. Future directions include personalized medicine, combination therapies, mechanistic insights, and ongoing long-term safety monitoring, collectively illuminating the promising landscape of febuxostat's multifaceted therapeutic potential.
非布司他最初作为一种黄嘌呤氧化酶抑制剂开发，用于治疗痛风患者的高尿酸血症，现已发展成为一种具有多方面应用的多功能治疗药物。本综述全面概述了非布司他的作用机制、在痛风管理中的有效性、心血管安全性、对肾脏和肝脏的影响、肌肉骨骼方面的应用、安全考量以及新兴的研究前景。非布司他的主要作用机制包括选择性抑制黄嘌呤氧化酶，从而减少尿酸生成。其药代动力学需要根据个体特征制定个性化给药策略。在痛风管理中，非布司他是一个有吸引力的替代药物，能有效降低尿酸水平、缓解症状并支持长期控制，尤其适用于对别嘌醇不耐受的患者。最近的研究表明了其心血管安全性，并且它表现出最小的肝毒性，使其适用于有肝脏合并症的患者。非布司他潜在的肾保护作用和预防肾结石的特性值得关注，特别是对于有肾脏问题的痛风患者。除痛风外，其抗炎特性提示了在肌肉骨骼疾病以及包括代谢综合征在内的更广泛临床背景中的应用。受其抗炎和抗氧化特性驱动，新兴研究探索了非布司他在心血管健康、神经疾病、类风湿关节炎和癌症治疗中的作用。未来的方向包括个性化医疗、联合治疗、作用机制的深入了解以及持续的长期安全性监测，这些共同揭示了非布司他多方面治疗潜力的广阔前景。
