Chronic tophaceous gout remains difficult to treat with available medications. Replacement of uricase, an enzyme essential for uric acid metabolism yet functionally deficient in humans, represents a promising therapy for uric acid lowering and resolution of tophi. Rasburicase, an available recombinant form of uricase, is limited in its use for gout due to immunogenicity.

Study results by Moreland, et al comparing febuxostat with allopurinol in Patients with hyperuricemia and gout are now published (N Engl J Med 353: 2505-2507). In this multicenter study, 760 patients received either febuxostat (80mg or 120mg) or allopurinol (300mg). 53% and 62% of patients receiving 80mg and 120mg, respectively, achieved serum urate concentration levels [...]