Abstract
This retrospective cohort study examined prescribing patterns for febuxostat in the United Kingdom before and after the 2019 US Food and Drug Administration (FDA) warning that it had a greater risk of mortality than allopurinol. Primary care prescribing data for both drugs was collected from England, Wales, and Northern Ireland between January 2017 and December 2020. Results of a Mann-Whitney U test showed that prescribing rates for allopurinol were higher than febuxostat in all months of the study in all three countries, with a median of 9.14 prescriptions per 1000 population compared to 8.88 prescriptions per 1000 population for febuxostat. Febuxostat prescribing rates increased after February 2019 in England (median difference = 0.029, p < 0.001), Wales (median difference = 0.028, p < 0.000), and Northern Ireland (median difference = 0.020, p = 0.015). This modest increase indicates a lack of reaction among prescribers to the FDA warning.