Advances in Xanthine Oxidase Inhibition: A Review of Potential Bioactive Synthetic Compounds

Hyperuricemia and gout are conditions that continue to present significant therapeutic challenges, mainly due to limitations of current treatments which may cause adverse effects such as hypersensitivity, hepatotoxicity, and cardiovascular risks. Additionally, the development of new drugs faces obstacles including toxicity, low bioavailability, and potential drug interactions. In this context, the search for new synthetic xanthine oxidase inhibitors is essential to improve treatment efficacy, selectivity, and safety. New molecules can not only prolong the duration of therapeutic effects but also minimize adverse reactions. Moreover, several compounds under investigation exhibit additional pharmacological activities, such as anti-inflammatory, antioxidant, anticholinesterase, and anticancer properties. Recent research trends also include the use of artificial intelligence, computational modeling, and the exploration of natural products—such as flavonoids and alkaloids—as sources of inspiration for new synthetic inhibitors. Furthermore, strategies like combination therapies are being explored to enhance uric acid excretion. This review conducted a systematic search for new xanthine oxidase inhibitors (2025–2020), focusing on high-impact publications and organizing the compounds according to their molecular scaffolds (number of rings). This review highlights recent advances in the development of synthetic xanthine oxidase inhibitors, emphasizing their structural diversity and the continuous relevance of this study area. The discovery of new drug candidates has the potential to provide more effective and safer therapeutic options for patients in the near future.