Sun Yi, Li Liang, Zhou Tian-Yan, Lu Wei
Yao Xue Xue Bao. 2014 Dec;49(12):1674-83.
This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
本研究旨在通过基于模型的荟萃分析比较非布司他和别嘌醇在痛风患者中的尿酸降低反应率。文献检索确定了22项痛风临床试验，共有43个符合我们纳入标准的独特治疗组，研究共纳入6365例痛风患者。别嘌醇和非布司他的反应率分别用Tmax模型和Emax模型进行表征，并测试了基线血清尿酸（sUA）和患者类型对药物效果的影响。结果表明，别嘌醇平均最大反应率可达50.8%，而非布司他能在很短时间内达到100%的反应率，其半数有效量（ED50）为34.3mg。协变量分析显示，基线sUA对别嘌醇的反应率有负面影响，对非布司他预测的ED50有正面影响。对于先前别嘌醇治疗反应不足的患者，其平均反应率约为别嘌醇反应者患者的一半。
