Comparative cardiovascular risk in users versus non-users of xanthine oxidase inhibitors and febuxostat versus allopurinol users

非布索坦 别嘌呤醇 医学 痛风 黄嘌呤氧化酶 黄嘌呤氧化酶抑制剂 危险系数 狼牙棒 倾向得分匹配 内科学 高尿酸血症 尿酸 心肌梗塞 生物化学 经皮冠状动脉介入治疗 置信区间 化学
作者
Chengsheng Ju,Rachel Wing Chuen Lai,Ka Hou Christien Li,Joshua Hung,Jenny Chi Ling Lai,Jeffery Ho,Yingzhi Liu,Man-Fung Tsoi,Tong Liu,Bernard Man Yung Cheung,Ian C. K. Wong,Lai‐Shan Tam,Gary Tse
出处
期刊:Rheumatology [Oxford University Press]
卷期号:59 (9): 2340-2349 被引量:66
标识
DOI:10.1093/rheumatology/kez576
摘要

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.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.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).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.
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