Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis
Abstract The cardiovascular (CV) safety of febuxostat compared to allopurinol for the treatment of hyperuricemia among Asian patients is uncertain. In this study, we conducted a systematic review and meta‐analysis to compare the CV safety profiles of febuxostat with allopurinol in Asian patients wit...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Clinical and Translational Science |
| Online Access: | https://doi.org/10.1111/cts.13757 |
| _version_ | 1797244822526885888 |
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| author | Jian‐hao Deng Peng‐hui Lai Li‐shan Xie Shu‐sheng Qiu De‐sheng Qiu Jia‐xing Zhang |
| author_facet | Jian‐hao Deng Peng‐hui Lai Li‐shan Xie Shu‐sheng Qiu De‐sheng Qiu Jia‐xing Zhang |
| author_sort | Jian‐hao Deng |
| collection | DOAJ |
| description | Abstract The cardiovascular (CV) safety of febuxostat compared to allopurinol for the treatment of hyperuricemia among Asian patients is uncertain. In this study, we conducted a systematic review and meta‐analysis to compare the CV safety profiles of febuxostat with allopurinol in Asian patients with hyperuricemia. A total of 13 studies were included. On the basis of the pooled results of cohort studies, febuxostat users were at a significantly higher risk for acute coronary syndrome (ACS; hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 1.03–1.09, p < 0.01), atrial fibrillation (HR: 1.19, 95% CI: 1.05–1.35, p < 0.01) than allopurinol users, whereas no significant difference between febuxostat and allopurinol existed for urgent coronary revascularization (HR: 1.07, 95% CI: 0.98–1.16, p = 0.13), and stroke (HR: 0.96, 95% CI: 0.91–1.01, p = 0.13). Nevertheless, that difference in results of acute decompensated heart failure (ADHF; HR: 0.73, 95% CI: 0.35–1.53, p = 0.40) and all‐cause death (HR = 0.86, 95% CI: 0.49–1.51, p = 0.60) was not significant based on randomized controlled trials. In the Chinese subgroup, febuxostat could increase the risk of ADHF (HR: 1.22, 95% CI: 1.01–1.48, p < 0.05), CV death (HR: 1.25, 95% CI: 1.03–1.50, p < 0.05), and all‐cause mortality (HR: 1.07, 95% CI: 1.01–1.14, p < 0.05) compared to allopurinol. In conclusion, the use of febuxostat, compared with allopurinol among Asian patients, was associated with a significantly increased risk of adverse CV events. |
| first_indexed | 2024-04-24T19:17:07Z |
| format | Article |
| id | doaj.art-17c3a386654e4db8b0b9b439910e7b55 |
| institution | Directory Open Access Journal |
| issn | 1752-8054 1752-8062 |
| language | English |
| last_indexed | 2024-04-24T19:17:07Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Science |
| spelling | doaj.art-17c3a386654e4db8b0b9b439910e7b552024-03-26T04:50:32ZengWileyClinical and Translational Science1752-80541752-80622024-03-01173n/an/a10.1111/cts.13757Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysisJian‐hao Deng0Peng‐hui Lai1Li‐shan Xie2Shu‐sheng Qiu3De‐sheng Qiu4Jia‐xing Zhang5Pharmacy Department Longyan Second Hospital Longyan ChinaPharmacy Department Longyan Second Hospital Longyan ChinaPharmacy Department Longyan Second Hospital Longyan ChinaPharmacy Department Longyan Second Hospital Longyan ChinaNeurology Department Longyan Second Hospital Longyan ChinaPharmacy Department Guizhou Provincial People's Hospital Guiyang ChinaAbstract The cardiovascular (CV) safety of febuxostat compared to allopurinol for the treatment of hyperuricemia among Asian patients is uncertain. In this study, we conducted a systematic review and meta‐analysis to compare the CV safety profiles of febuxostat with allopurinol in Asian patients with hyperuricemia. A total of 13 studies were included. On the basis of the pooled results of cohort studies, febuxostat users were at a significantly higher risk for acute coronary syndrome (ACS; hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 1.03–1.09, p < 0.01), atrial fibrillation (HR: 1.19, 95% CI: 1.05–1.35, p < 0.01) than allopurinol users, whereas no significant difference between febuxostat and allopurinol existed for urgent coronary revascularization (HR: 1.07, 95% CI: 0.98–1.16, p = 0.13), and stroke (HR: 0.96, 95% CI: 0.91–1.01, p = 0.13). Nevertheless, that difference in results of acute decompensated heart failure (ADHF; HR: 0.73, 95% CI: 0.35–1.53, p = 0.40) and all‐cause death (HR = 0.86, 95% CI: 0.49–1.51, p = 0.60) was not significant based on randomized controlled trials. In the Chinese subgroup, febuxostat could increase the risk of ADHF (HR: 1.22, 95% CI: 1.01–1.48, p < 0.05), CV death (HR: 1.25, 95% CI: 1.03–1.50, p < 0.05), and all‐cause mortality (HR: 1.07, 95% CI: 1.01–1.14, p < 0.05) compared to allopurinol. In conclusion, the use of febuxostat, compared with allopurinol among Asian patients, was associated with a significantly increased risk of adverse CV events.https://doi.org/10.1111/cts.13757 |
| spellingShingle | Jian‐hao Deng Peng‐hui Lai Li‐shan Xie Shu‐sheng Qiu De‐sheng Qiu Jia‐xing Zhang Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis Clinical and Translational Science |
| title | Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis |
| title_full | Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis |
| title_fullStr | Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis |
| title_full_unstemmed | Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis |
| title_short | Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta‐analysis |
| title_sort | cardiovascular safety of febuxostat versus allopurinol among the asian patients with or without gout a systematic review and meta analysis |
| url | https://doi.org/10.1111/cts.13757 |
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