Hyperuricemia is defined as the increase in uric acid when it exceeds its solubility limit, about 6.8 mg/dl. Persistent hyperuricemia causes diseases such as gouty arthritis, arthropathy, urolithiasis, and nephropathy. We present the clinical case of a 46-year-old patient with gout and persistent hyperuricemia; he presented cutaneous hypersensitivity to allopurinol and febuxostat and, for this reason, the patient stopped the treatment. After undergoing a 5-day new febuxostat desensitization protocol, he tolerated the drug without adverse effects. This case report highlights the importance of allergy desensitization if there’s no other therapeutic option in patients with hypersensitivity to allopurinol and febuxostat.
Cite this paper
Alonso-Bello, C. D. , Matías-Carmona, M. , Castaneda-ávila, V. I. , Aranda-Cano, E. and Castrejón-Vázquez, M. I. (2022). Febuxostat: Successful Desensitization Protocol. Open Access Library Journal, 9, e8481. doi: http://dx.doi.org/10.4236/oalib.1108481.
Becker, M.A., Schumacher, H.R., Wortmann, R.L., MacDonald, P.A., Eustace, D., Streit, J., et al. (2005) Febuxostat Compared with Allopurinol in Patients with Hyperuricemia and Gout. The New England Journal of Medicine, 353, 2450-2461.
https://doi.org/10.1056/NEJMoa050373
Stamp, L.K., Day, R.O. and Yun, J. (2016) Allopurinol Hypersensitivity: Investigating the Cause and Minimizing the Risk. Nature Reviews Rheumatology, 12, 235-242. https://doi.org/10.1038/nrrheum.2015.132
Lin, C.W., Huang, W.L., Chao, P.H., Chen, W.W. and Hsiao, F.Y. (2019) Risk of Cutaneous Adverse Reactions Associated with Allopurinol or Febuxostat in Real-World Patients: A Nationwide Study. International Journal of Clinical Practice, 73, e13316. https://doi.org/10.1111/ijcp.13316
Jordan, A. and Gresser, U. (2018) Side Effects and Interactions of Xanthine Oxidase Inhibitor Febuxostat. Pharmaceuticals (Basel), 11, 51.
https://doi.org/10.3390/ph11020051
Chohan, S. (2011) Safety and Efficacy of Febuxostat Treatment in Subjects with Gout and Severe Alopurinol Adverse Reactions. The Journal of Rheumatology, 38, 1957-1959. https://doi.org/10.3899/jrheum.110092
Di Paolo, C., Minetti, S., Mineni, M., Inverardi, S., Rizzini, F.L., Cinquini, M., et al. (2015) Desensitization to Febuxostat: Report of Two Cases. The Journal of Allergy and Clinical Immunology: In Practice, 3, 633-636.
https://doi.org/10.1016/j.jaip.2015.01.022
Sulaiman, N., Othman, Z.A., Shahril, N.S., Rashid, A.M., Faeez, M.D. and Noh, M. (2017) Successful Febuxostat Desensitization in a Patient with Febuxostat Hypersensitivity: A Malaysian Experience. SAGE Open Medical Case Reports, 5, 2050313X17749080. https://doi.org/10.1177/2050313X17749080
Yeon-Hau, H.L. and Logan, J.L. (2017) Cross-Reactions between Allopurinol and Febuxostat. American Journal of Medicine, 130, e67-e68.
https://doi.org/10.1016/j.amjmed.2016.08.042
