ObjectiveTo compare the effectiveness, safety, and cost outcomes of brand-name febuxostat (feburic) and generic febuxostat (feuri) in patients with hyperuricemia or gout in a real-world clinical setting.MethodsWe conducted a retrospective cohort study using electronic medical records from Taichung Veterans General Hospital between November 2021 and December 2023. Adult patients with hyperuricemia or gout who initiated febuxostat therapy and had no prior urate-lowering treatment in the preceding 3 months were included. Serum uric acid levels were assessed at baseline, 3 months, and the final follow-up. Propensity score matching (1:1) was applied to balance baseline demographic, clinical, laboratory, cardiovascular, and renal characteristics. Clinical outcomes, laboratory parameters, and medication costs were compared between groups.ResultsBoth feuri and feburic were associated with significant reductions in serum uric acid levels after 3 months of treatment. At the 3-month assessment, the mean serum uric acid level was modestly lower in the feuri group (5.41 ± 2.06 mg/dL) than in the feburic group (5.75 ± 2.12 mg/dL; P = .001). At the final follow-up, serum uric acid levels remained numerically lower in the feuri group, although the difference was not statistically significant (P = .07). The feuri group was prescribed a lower final daily dose, which was associated with lower annual medication costs. The proportions of patients achieving recommended uric acid goals were similar between groups, suggesting broadly comparable clinical effectiveness in routine practice. After propensity score matching (n = 486 pairs), no significant differences were observed between groups in cardiovascular, renal, or overall safety outcomes.ConclusionsThis real-world study suggests that generic febuxostat is associated with safety outcomes comparable to those of the brand-name formulation and may be prescribed at lower doses and lower medication costs in routine clinical practice.
Tsai et al. (2026) studied this question.