{"doi":"10.1002/acr.25283","title":"Superiority of <scp>Low‐Dose</scp> Benzbromarone <scp>Add‐On</scp> to <scp>Low‐Dose</scp> Febuxostat Compared With Febuxostat Monotherapy in Gout With <scp>Combined‐Type</scp> Hyperuricemia","abstract":"OBJECTIVE: There is an unmet need for simpler urate-lowering therapy (ULT) regimens that achieve the serum urate target and improve the overall quality of gout care. We report a comparative effectiveness trial of febuxostat monotherapy versus benzbromarone add-on to low-dose febuxostat in gout specifically with combined renal urate underexcretion and overload. METHODS: 1:1 randomly assigned to febuxostat and benzbromarone combination therapy (initially febuxostat at 20 mg/day, with benzbromarone at 25 mg/day added onto 20 mg/day of febuxostat if not at target) or febuxostat monotherapy (initially 20 mg/day, escalating to 40 mg/day if not at target). The primary end point at 12 weeks was the proportion achieving a serum urate (SU) level <360 μmol/L. Other outcomes included altered liver and kidney function, new-onset urolithiasis, and gout flares. RESULTS: There were 250 participants randomized; 219 completed 12-week treatment. More patients in the febuxostat and benzbromarone combination group achieved the SU target compared to patients in the febuxostat monotherapy group (75.5% vs 47.7%; odds ratio 3.37 [95% confidence interval 1.90-5.98]). Safety profiles were comparable between the two groups. CONCLUSION: Simply adding on low-dose benzbromarone (25 mg/day) to low-dose (20 mg/day) febuxostat showed superior urate lowering compared to febuxostat monotherapy in gout with a combined-type hyperuricemia. For selected patients, expedited achievement of the SU target in more than 75% of patients using one titration step and low xanthine oxidase inhibitor and uricosuric doses is a potential alternative to standard ULT regimens.","journal":"Arthritis Care & Research","year":2023,"id":347247,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9446,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":860178,"name":"Mingshu Sun","orcid":"0000-0001-9671-5323","position":1,"is_corresponding":false},{"id":860174,"name":"Fei Yan","orcid":"0000-0002-3381-1489","position":2,"is_corresponding":false},{"id":258556,"name":"Nicola Dalbeth","orcid":"0000-0003-4632-4476","position":3,"is_corresponding":false},{"id":756362,"name":"Yuwei He","orcid":"0000-0002-5107-5323","position":4,"is_corresponding":false},{"id":631893,"name":"Xinde Li","orcid":"0000-0002-1529-4537","position":5,"is_corresponding":false},{"id":860175,"name":"Han Qi","orcid":"0000-0002-0720-2305","position":6,"is_corresponding":false},{"id":860179,"name":"Ying Chen","orcid":"0000-0002-7772-343X","position":7,"is_corresponding":false},{"id":1088731,"name":"Xuan Yuan","orcid":"0000-0002-0622-0755","position":8,"is_corresponding":false},{"id":926352,"name":"Maichao Li","orcid":null,"position":9,"is_corresponding":false},{"id":756365,"name":"Aichang Ji","orcid":"0000-0002-3726-6844","position":10,"is_corresponding":false},{"id":477225,"name":"Robert Terkeltaub","orcid":"0000-0001-5368-7473","position":11,"is_corresponding":false},{"id":631894,"name":"Changgui Li","orcid":"0000-0002-4622-3731","position":12,"is_corresponding":false},{"id":756359,"name":"Xiaomei Xue","orcid":"0000-0002-1430-0130","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T01:11:57.720122Z","pmid":"38130040","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}