Response: Re: To Treat or Not to Treat? Effect of Urate-Lowering Therapy on Renal Function, Blood Pressure and Safety in Patients with Asymptomatic Hyperuricemia
Journal
Journal of the American Board of Family Medicine
Journal Volume
35
Journal Issue
3
Pages
642
Date Issued
2022
Author(s)
Tien, YY
Abstract
To the Editor: We would like to thank Dr. Kawada for his interest in our article. He mentioned the meta-analysis by Gao et al, in which a better safety outcome for febuxostat compared with allopurinol was observed in gout patients in terms of urgent coronary revascularization and stroke.1 In our network meta-analysis (NMA),2 trials reporting cardiovascular events all used febuxostat as the treatment, so we could not compare its cardiovascular effect to allopurinol in patients with asymptomatic hyperuricemia. Besides, the cardiovascular events in our analysis included several types of cardiovascular diseases, such as heart failure and non-fatal myocardial infarction. Our study, nevertheless, found that patients using febuxostat had significantly lower diastolic blood pressure than those using placebo, indicating that febuxostat has a cardiovascular protective effect. Similar effects on diastolic blood pressure were not observed in the allopurinol group. We need more randomized controlled trials to clarify this issue.
SDGs
Publisher
AMER BOARD FAMILY MEDICINE
Type
letter