Two commonly prescribed medications for gout treatment are febuxostat and benzbromarone. However, their clinical efficacy remains a subject of debate.
A European Review for Medical and Pharmacological Sciences study concluded that Febuxostat significantly benefits renal function-related indexes, including the estimated glomerular filtration rate (eGFR), Cr, and blood urea nitrogen (BUN). In contrast, benzbromarone is more effective in reducing uric acid (UA) and has relatively less hepatotoxicity.

This meta-analysis aimed to evaluate the efficacy of febuxostat and benzbromarone in treating gout.
The search included PubMed, Embase, and the Cochrane Library for articles on febuxostat and benzbromarone from inception to January 7, 2023. Titles and abstracts were reviewed using predefined criteria, and data were extracted independently. The Newcastle-Ottawa Scale was used to assess study quality, and continuous variables were expressed as standard mean square error by STATA 16. Sensitivity analysis was conducted by randomly removing a study, and heterogeneity was analyzed through funnel plots and Egger's test.
Key findings from the study are:
A total of 1,043 publications were retrieved from the databases.
Owing to duplication, 45 publications were excluded.
Fourteen studies remained after screening titles and abstracts. Seven studies met the inclusion criteria.
Meta-analysis showed that the uric acid (UA)--reducing the effect of febuxostat is better than benzbromarone.
Febuxostat demonstrated a better ability to improve the eGFR and reduce Cr and BUN.
Considering hepatotoxicity, benzbromarone was not as potent as febuxostat in increasing alanine transaminase (ALT) and aspartate transaminase (AST). This suggests that benzbromarone has less hepatotoxicity.
There was no significant difference in the effect on blood lipid levels between the two drugs.
They said Febuxostat improves renal function and benefits indices like eGFR, Cr, and BUN, while benzbromarone is better at lowering UA and causes less liver damage.
Reference:
Yan CQ et al. Comparison of the efficacy of febuxostat vs. benzbromarone in the treatment of gout: a meta-analysis in Chinese gout patients. Eur Rev Med Pharmacol Sci. 2023 Dec;27(24):11988-12003.