Lin Ting-Syuan, Lin Yen-Liang, Hsu Chiu-Hao, Hsieh Song-Chou, Shau Wen-Yi, Yang Wei-Shiung, Chen Chi-Ling
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
Front Cardiovasc Med. 2025 Jul 10;12:1541307. doi: 10.3389/fcvm.2025.1541307. eCollection 2025.
Gout is caused by hyperuricemia and is associated with cardiovascular diseases. Treatment for hyperuricemia primarily involves urate-lowering medications. Some trials showed higher cardiovascular mortality rates with febuxostat compared to allopurinol in gout patients. However, data on the cardiovascular safety of benzbromarone compared to allopurinol is limited, and there is no data comparing benzbromarone to febuxostat. This study aims to assess the cardiovascular safety of benzbromarone, febuxostat, and allopurinol in gout patients.
A comprehensive search was conducted across PubMed and EMBASE from their inception to August 2024. Inclusion criteria were randomized controlled trials (RCTs) and cohort studies including adult patients with the diagnosis of gout, with urate-lowering medications. The outcome was the incidence of major adverse cardiovascular events. This systematic review and network meta-analysis were recorded in INPLASY with the ID INPLASY202460049.
A total of 176 studies were identified through the database search. There were 119 articles identified in EMBASE and 57 articles identified in PubMed. Following screening and review, 17 qualified studies (5 RCTs) were included in the network meta-analysis. The relative cardiovascular event risk (risk ratio, RR) for benzbromarone compared to febuxostat is 0.82 (95% CI 0.61-1.09), and for benzbromarone compared to allopurinol, the RR is 0.87 (95% CI 0.75-1.01). The RR for febuxostat compared to allopurinol is 1.08 (95% CI 0.97-1.20).
Our network meta-analysis suggests a subtle trend indicating a lower risk of cardiovascular events for benzbromarone compared to both febuxostat and allopurinol in gout patients, although not statistically significant.
https://inplasy.com/inplasy-2024-6-0049/, identifier INPLASY202460049.
痛风由高尿酸血症引起，且与心血管疾病相关。高尿酸血症的治疗主要涉及降尿酸药物。一些试验表明，与别嘌醇相比，非布司他使痛风患者的心血管死亡率更高。然而，与别嘌醇相比，关于苯溴马隆心血管安全性的数据有限，且没有将苯溴马隆与非布司他进行比较的数据。本研究旨在评估苯溴马隆、非布司他和别嘌醇在痛风患者中的心血管安全性。
从创刊至2024年8月，在PubMed和EMBASE上进行了全面检索。纳入标准为随机对照试验（RCT）和队列研究，包括诊断为痛风且正在使用降尿酸药物的成年患者。结局指标为主要不良心血管事件的发生率。该系统评价和网状Meta分析已在INPLASY注册，注册号为INPLASY202460049。
通过数据库检索共识别出176项研究。在EMBASE中识别出119篇文章，在PubMed中识别出57篇文章。经过筛选和评审，17项合格研究（5项RCT）被纳入网状Meta分析。与非布司他相比，苯溴马隆的相对心血管事件风险（风险比，RR）为0.82（95%CI 0.61-1.09），与别嘌醇相比，RR为0.87（95%CI 0.75-1.01）。与别嘌醇相比，非布司他的RR为1.08（95%CI 0.97-1.20）。
我们的网状Meta分析表明，尽管无统计学意义，但有微妙趋势显示，与非布司他和别嘌醇相比，苯溴马隆在痛风患者中发生心血管事件的风险较低。
https://inplasy.com/inplasy-2024-6-0049/，标识符INPLASY202460049。
