Gout is a very common type of arthritis that can affect people of all age groups. It causes sharp, acute pain, swelling, redness, and tenderness in one or more joints, most commonly the big toe. The affected joint also becomes swollen and painful to the point where even the weight of the bedsheet on it becomes unbearable.
In clinical practice, medications are currently the first line of treatment for gout, with Febuxostat and Allopurinol being the most routinely prescribed. However, investigations comparing the cardiovascular safety profile of febuxostat to that of Allopurinol have produced conflicting results. However, there is no conclusive evidence of a link between xanthine oxidase inhibitors and cardiovascular disease.
Gao L et al. did a review of relevant clinical studies published in recent years to thoroughly investigate the cardiovascular adverse events and death risks of febuxostat compared to Allopurinol in gout patients.
The researchers looked for articles published between March 1, 2000, and April 4, 2021, in MEDLINE and Embase. They then did a comprehensive review and meta-analysis of all relevant clinical trials to examine the cardiovascular safety of febuxostat against Allopurinol for chronic gout treatment.
Two reviewers chose studies independently, assessed research quality, and extracted data. Then, using random effects, risk ratios were calculated and given, along with 95%confidence intervals (CI). Two-hundred-twenty-four papers were eliminated from a total of 240 potentially relevant citations; 16 research were eventually included in the study.
Febuxostat was found to be safer than Allopurinol in terms of urgent coronary revascularization and stroke. Nonfatal myocardial infarction, cardiovascular-related mortality, and all-cause mortality, on the other hand, did not show this difference. In addition, no significant differences in cardiovascular-related and all-cause mortality were seen in any of the subgroups.
This study concluded that febuxostat had a low risk of cardiovascular complications in gout patients. In addition, as compared to Allopurinol, starting febuxostat did not raise the risk of death or major cardiovascular-related side events in patients.