在亚洲患者中,非布索坦与别嘌醇治疗高尿酸血症的心血管(CV)安全性尚不确定。在这项研究中,我们进行了系统评价和荟萃分析,以比较非布索坦与别嘌醇在亚洲高尿酸血症患者中的CV安全性.共纳入13项研究。根据队列研究的汇总结果,非布索坦使用者患急性冠脉综合征的风险显著增高(ACS;风险比[HR]:1.06,95%置信区间[CI]:1.03-1.09,p<0.01),心房颤动(HR:1.19,95%CI:1.05-1.35,p<0.01)而非布索坦和别嘌醇在紧急冠状动脉血运重建中没有显着差异(HR:1.07,95%CI:0.98-1.16,p=0.13),和卒中(HR:0.96,95%CI:0.91-1.01,p=0.13)。然而,根据随机对照试验,急性失代偿性心力衰竭(ADHF;HR:0.73,95%CI:0.35-1.53,p=0.40)和全因死亡(HR=0.86,95%CI:0.49-1.51,p=0.60)的结果差异不显著.在中文分组中,非布索坦可以增加ADHF的风险(HR:1.22,95%CI:1.01-1.48,p<0.05),CV死亡(HR:1.25,95%CI:1.03-1.50,p<0.05),和全因死亡率(HR:1.07,95%CI:1.01-1.14,p<0.05)与别嘌呤醇相比。总之,使用非布索坦,与亚洲患者的别嘌醇相比,与不良CV事件的风险显著增加相关.
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.