https://scholars.lib.ntu.edu.tw/handle/123456789/621306
標題: | The net clinical benefits of febuxostat versus allopurinol in patients with gout or asymptomatic hyperuricemia – A systematic review and meta-analysis | 作者: | Liu, Cheng-Wei Chang, Wei-Cheng Lee, Chiao-Chin Shau, Wen-Yi Hsu, Fu-Shun MAN-LING WANG Chen, Tsung-Chih Chiao Lo HWANG, JUEY-JEN |
關鍵字: | Allopurinol;Febuxostat;Hyperuricemia;Randomized-controlled trial | 公開日期: | 2019 | 出版社: | Elsevier B.V. | 卷: | 29 | 期: | 10 | 起(迄)頁: | 1011-1022 | 來源出版物: | Nutrition, Metabolism and Cardiovascular Diseases | 摘要: | Background and aims: Systemic reviews and meta-analyses suggest hyperuricemia is a cardiovascular risk factor. The effects of xanthine oxidase inhibitors on cardiac outcomes remain unclear. We assessed the effects of febuxostat and allopurinol on mortality and adverse reactions in adult patients with hyperuricemia. Methods and results: PubMed and EMBASE were searched to retrieve randomized controlled trials of febuxostat and allopurinol from January 2005 to July 2018. The meta-analysis consisted of 13 randomized controlled trials with a combined sample size of 13,539 patients. Febuxostat vs. allopurinol was not associated with an increased risk of cardiac-related mortality in the overall population (OR: 0.72, 95% CI: 0.24–2.13, P = 0.55). Regarding adverse skin reactions, the patients receiving febuxostat had significantly fewer adverse skin reactions than those receiving allopurinol treatment (OR: 0.50, 95% CI: 0.30–085, P = 0.01). Compared with allopurinol, febuxostat was associated with an improved safety outcome of cardiac-related mortality and adverse skin reactions (OR: 0.72, 95% CI: 0.55–0.96, P = 0.02). The net clinical outcome, composite of incident gout and the safety outcome, was not different significantly in the patients receiving febuxostat or allopurinol (OR: 1.04, 95% CI: 0.76–0.1.42, P = 0.79). In sensitivity analyses, a borderline significance was found in the patients randomized to febuxostat vs. allopurinol regarding cardiac-related mortality (OR: 1.29, 95% CI: 1.00–1.67, P = 0.05) after the CARES study was included. Conclusion: Febuxostat vs. allopurinol was associated with the improved safety outcome and have comparable mortality and net clinical outcome in patients with hyperuricemia. Registration number: PROSPERO(CRD42018091657). © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069976056&doi=10.1016%2fj.numecd.2019.06.016&partnerID=40&md5=fabb1176d205ae82ce8c9d0352429e86 https://scholars.lib.ntu.edu.tw/handle/123456789/621306 |
ISSN: | 0939-4753 | DOI: | 10.1016/j.numecd.2019.06.016 |
顯示於: | 醫學系 |
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