{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:00:42Z","timestamp":1791874842982,"version":"4.3.4"},"reference-count":27,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Febuxostat has superior renal safety to allopurinol, but data on its hepatic safety are limited. Thus we compared the hepatotoxicity of febuxostat and allopurinol, and the clinical factors associated with hepatotoxicity, in patients with gout and fatty liver disease (FLD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We included gout patients treated with allopurinol or febuxostat who were diagnosed with fatty liver based on ultrasonography or computed tomography. Hepatotoxicity was defined as follows: (1) elevation of aspartate aminotransferase (AST)\/alanine aminotransferase (ALT) at least 3\u00d7 the upper limit of normal, when the baseline AST\/ALT was normal; or (2) doubling of the baseline AST\/ALT, when the baseline AST\/ALT was elevated. The factors associated with hepatotoxicity were evaluated by Cox regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Of 134 patients identified with gout and FLD, 32 (23.9%) received febuxostat and 102 (76.1%) received allopurinol. There were no significant differences in age, body mass index, comorbidity, or disease severity between the groups; however, the incidence of hepatotoxicity was significantly lower in the febuxostat group (3\/32, 9.4%) than in the allopurinol group (36\/102, 35.3%, p = 0.005). Diabetes (HR 3.549, 95% CI 1.374\u20139.165, p = 0.009) and colchicine use (HR 11.518, 95% CI 5.515\u201324.054, p &lt; 0.001) were associated with a higher risk of hepatotoxicity, whereas febuxostat use was associated with a lower risk of hepatotoxicity (HR 0.282, 95% CI 0.086\u20130.926, p = 0.037).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>In the 32 patients studied, febuxostat was well tolerated in patients with gout and FLD. However, the presence of diabetes and colchicine use may increase the risk of hepatotoxicity.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.180761","type":"journal-article","created":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T07:27:31Z","timestamp":1542266851000},"page":"527-531","source":"Crossref","is-referenced-by-count":25,"title":["Hepatic Safety of Febuxostat Compared with Allopurinol in Gout Patients with Fatty Liver Disease"],"prefix":"10.3899","volume":"46","author":[{"given":"Jung Sun","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jebum","family":"Won","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oh Chan","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Soo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Seon","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Gil","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Keun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8722-3124","authenticated-orcid":false,"given":"Seokchan","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2018,11,15]]},"reference":[{"key":"2019050109251921000_46.5.527.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.1999.00041.x"},{"key":"2019050109251921000_46.5.527.2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H121"},{"key":"2019050109251921000_46.5.527.3","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1053\/j.ajkd.2016.07.001","article-title":"Febuxostat in hyperuricemic patients with advanced CKD","volume":"68","author":"Lim","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2019050109251921000_46.5.527.4","unstructured":"National Institutes of Health and LiverTox . Drug record: Febuxostat. [Internet. Accessed October 29, 2018.] Available from: https:\/\/livertox.nlm.nih.gov\/Febuxostat.htm"},{"key":"2019050109251921000_46.5.527.5","unstructured":"National Institutes of Health and LiverTox . Drug record: Allopurinol. [Internet. Accessed October 29, 2018.] Available from: https:\/\/livertox.nlm.nih.gov\/Allopurinol.htm"},{"key":"2019050109251921000_46.5.527.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050373"},{"key":"2019050109251921000_46.5.527.7","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1002\/hep.28403","article-title":"Febuxostat-induced acute liver injury","volume":"63","author":"Bohm","year":"2016","journal-title":"Hepatology"},{"key":"2019050109251921000_46.5.527.8","first-page":"297","article-title":"Febuxostat: hepatic failure","volume":"22","year":"2013","journal-title":"Prescrire Int"},{"key":"2019050109251921000_46.5.527.9","doi-asserted-by":"publisher","DOI":"10.3109\/03009741003742797"},{"key":"2019050109251921000_46.5.527.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.11.021"},{"key":"2019050109251921000_46.5.527.11","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e3282f4b1ed"},{"key":"2019050109251921000_46.5.527.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2007.00072.x"},{"key":"2019050109251921000_46.5.527.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208237"},{"key":"2019050109251921000_46.5.527.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.008"},{"key":"2019050109251921000_46.5.527.15","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21848"},{"key":"2019050109251921000_46.5.527.16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jceh.2015.01.003","article-title":"Clinical and biochemical profile of tuberculosis in patients with liver cirrhosis","volume":"5","author":"Sharma","year":"2015","journal-title":"J Clin Exp Hepatol"},{"key":"2019050109251921000_46.5.527.17","first-page":"545","article-title":"The involvement and mechanism of febuxostat in non-alcoholic fatty liver disease cells","volume":"32","author":"Tang","year":"2018","journal-title":"J Biol Regul Homeost Agents"},{"key":"2019050109251921000_46.5.527.18","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1053\/j.gastro.2015.03.006","article-title":"Features and outcomes of 899 patients with drug-induced liver injury: The DILIN prospective study","volume":"148","author":"Chalasani","year":"2015","journal-title":"Gastroenterology"},{"key":"2019050109251921000_46.5.527.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.02.007"},{"key":"2019050109251921000_46.5.527.20","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.04.001"},{"key":"2019050109251921000_46.5.527.21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5005\/jp-journals-10018-1140","article-title":"Drug-induced liver disease in patients with diabetes mellitus","volume":"5","author":"Iryna","year":"2015","journal-title":"Euroasian J Hepatogastroenterol"},{"key":"2019050109251921000_46.5.527.22","first-page":"598","article-title":"[Antipyrine clearance as a measure of drug metabolism in patients with diabetes mellitus]","volume":"22","author":"Oltmanns","year":"1984","journal-title":"Z Gastroenterol"},{"key":"2019050109251921000_46.5.527.23","unstructured":"National Institutes of Health and LiverTox . Drug record: Colchicine. [Internet. Accessed October 29, 2018.] Available from: https:\/\/livertox.nlm.nih.gov\/Colchicine.htm."},{"key":"2019050109251921000_46.5.527.24","doi-asserted-by":"crossref","first-page":"e120","DOI":"10.14309\/crj.2017.120","article-title":"Colchicine-induced hepatotoxicity","volume":"4","author":"Abbott","year":"2017","journal-title":"ACG Case Rep J"},{"key":"2019050109251921000_46.5.527.25","first-page":"S98","article-title":"Colchicine: an unusual cause of acute hepatitis","volume":"98","author":"Gautam","year":"2003","journal-title":"Am J Gastroenterol Suppl"},{"issue":"suppl 1","key":"2019050109251921000_46.5.527.26","doi-asserted-by":"crossref","first-page":"i4","DOI":"10.1093\/rheumatology\/kex453","article-title":"Update on colchicine, 2017","volume":"57","author":"Slobodnick","year":"2018","journal-title":"Rheumatology"},{"key":"2019050109251921000_46.5.527.27","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0676.2001.021002129.x"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.180761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T13:10:20Z","timestamp":1556716220000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.180761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,15]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,1]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.3899\/jrheum.180761"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.180761","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,15]]}}}