Comparative cardiovascular risk in users versus non-users of xanthine oxidase inhibitors and febuxostat versus allopurinol users
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AbstractObjectives: The aim of this study is to determine major adverse cardiovascular events (MACE) and all-cause mortality comparing between xanthine oxidase inhibitors (XOIs) and non-XOI users, and between allopurinol and febuxostat.

Methods: This is a retrospective cohort study of gout patients prescribed anti-hyperuricemic medications between 2013 and 2017 using a territory-wide administrative database. XOI users were matched 1:1 to XOI non-users using propensity scores. Febuxostat users were matched 1:3 to allopurinol users. Subgroup analyses were conducted based on colchicine use.

Results: Of the 13 997 eligible participants, 3607 (25.8%) were XOI users and 10 390 (74.2%) were XOI non-users. After propensity score matching, compared with non-users (n = 3607), XOI users (n = 3607) showed similar incidence of MACE (hazard ratio [HR]: 0.997, 95% CI, 0.879, 1.131; P>0.05) and all-cause mortality (HR = 0.972, 95% CI 0.886, 1.065, P=0.539). Febuxostat (n = 276) users showed a similar risk of MACE compared with allopurinol users (n = 828; HR: 0.672, 95% CI, 0.416, 1.085; P=0.104) with a tendency towards a lower risk of heart failure-related hospitalizations (HR = 0.529, 95% CI 0.272, 1.029; P=0.061). Concurrent colchicine use reduced the risk for all-cause mortality amongst XOI users (HR = 0.671, 95% 0.586, 0.768; P<0.001).

Conclusion: In gout patients, XOI users showed similar risk of MACE and all-cause mortality compared with non-users. Compared with allopurinol users, febuxostat users showed similar MACE and all-cause mortality risks but lower heart failure-related hospitalizations.
All Author(s) ListChengsheng Ju, Rachel Wing Chuen Lai, Ka Hou Christien Li, Joshua Kai Fung Hung, Jenny C L Lai, Jeffery Ho, Yingzhi Liu, Man Fung Tsoi, Tong Liu, Bernard Man Yung Cheung, Ian Chi Kei Wong, Lai Shan Tam, Gary Tse
Journal nameRheumatology
Year2020
Month9
Volume Number59
Issue Number9
PublisherOxford University Press
Pages2340 - 2349
ISSN1462-0324
eISSN1462-0332
LanguagesEnglish-United States
Keywordsallopurinol, cardiovascular risk, febuxostat; gout, myocardial infarction, xanthine oxidase inhibitor

Last updated on 2021-28-11 at 23:44