Affiliation:
1. Pharmacy Department Longyan Second Hospital Longyan China
2. Neurology Department Longyan Second Hospital Longyan China
3. Pharmacy Department Guizhou Provincial People's Hospital Guiyang China
Abstract
AbstractThe 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.