Eun Yeonghee, Han Heewon, Kim Kyunga, Kang Seonyoung, Lee Seulkee, Kim Hyungjin, Lee Jaejoon, Koh Eun-Mi, Cha Hoon-Suk
Division of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ther Adv Musculoskelet Dis. 2022 Aug 10;14:1759720X221116409. doi: 10.1177/1759720X221116409. eCollection 2022.
In previous studies, cardiovascular (CV) risk was increased in patients with gout. The effects of uric acid-lowering therapy on CV risk in gout patients have been investigated in numerous studies; however, allopurinol and benzbromarone have rarely been compared.
To compare CV risk based on allopurinol and benzbromarone treatment in Korean gout patients.
A nationwide population-based retrospective cohort study.
We used South Korea database of the Health Insurance Review and Assessment (HIRA) service to identify gout patients ⩾18 years of age who newly started allopurinol or benzbromarone between 2009 and 2015. The primary outcome of the study was the occurrence of a composite CV endpoint, which included coronary revascularization, hospitalization due to myocardial infarction, ischemic stroke, and transient ischemic attack. Cox proportional hazard regression analysis and Kaplan-Meier curves were used for analysis.
The study included 257,097 allopurinol initiators and 7868 benzbromarone initiators. Compared with allopurinol initiators, the adjusted hazard ratio (aHR) of the composite CV endpoint of benzbromarone initiators was 1.01 [95% confidence interval (CI): 0.83-1.21], which was not significantly different. The results did not change even when 1:3 propensity score matching was performed for baseline characteristics. In subgroup analysis of high-risk patients with CV disease, significant difference was not observed between allopurinol and benzbromarone initiators.
In this study, significant difference was not found in CV risk between allopurinol and benzbromarone initiators. In the high-CV-risk group, the incidence of CV events did not differ between allopurinol and benzbromarone initiators.
在先前的研究中，痛风患者的心血管（CV）风险增加。众多研究已对降尿酸治疗对痛风患者CV风险的影响进行了调查；然而，别嘌醇和苯溴马隆很少被比较。
比较韩国痛风患者使用别嘌醇和苯溴马隆治疗后的CV风险。
一项基于全国人群的回顾性队列研究。
我们使用韩国健康保险审查与评估（HIRA）服务数据库，识别出2009年至2015年间新开始使用别嘌醇或苯溴马隆的18岁及以上痛风患者。该研究的主要结局是复合CV终点事件的发生，包括冠状动脉血运重建、因心肌梗死住院、缺血性中风和短暂性脑缺血发作。采用Cox比例风险回归分析和Kaplan-Meier曲线进行分析。
该研究纳入了257,097名开始使用别嘌醇的患者和7,868名开始使用苯溴马隆的患者。与开始使用别嘌醇的患者相比，开始使用苯溴马隆的患者复合CV终点的调整后风险比（aHR）为1.01[95%置信区间（CI）：0.83-1.21]，无显著差异。即使对基线特征进行1:3倾向评分匹配，结果也未改变。在CV疾病高危患者的亚组分析中，开始使用别嘌醇和苯溴马隆的患者之间未观察到显著差异。
在本研究中，开始使用别嘌醇和苯溴马隆的患者在CV风险方面未发现显著差异。在高CV风险组中，开始使用别嘌醇和苯溴马隆的患者CV事件发生率无差异。
