Febuxostat leads to better cardiovascular outcomes compared to allopurinol in patients with advanced chronic kidney disease: A Population-based Cohort Study.
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引用次数: 0
Abstract
Objective: Hyperuricemia is a risk factor for cardiovascular disease complications in patients with chronic kidney disease. The impact of febuxostat on cardiovascular disease in advanced chronic kidney disease remains unclear. This study aimed to explore the cardiovascular benefits of xanthine oxidase inhibitors, particularly febuxostat and allopurinol, in patients with advanced chronic kidney disease.
Methods: A retrospective population-based cohort study was conducted using data from Taiwan's National Health Insurance Research Database (NHIRD) (2006-2017). The TriNetX dataset served as an external validation dataset. The study involved 13,187 patients with advanced chronic kidney disease treated with febuxostat or allopurinol. After propensity score matching, a balanced cohort of 976 patients (488 in each arm) was created. Hazard ratios (HRs) were calculated for all-cause mortality and hospitalizations, utilizing the competing risk regression model.
Results: Febuxostat was associated with lower all-cause mortality (HR, 0.79; 95% confidence interval [CI], 0.64-0.98) and fewer hospitalizations (HR, 0.53; 95% CI, 0.44-0.63) than allopurinol. After adjustments, febuxostat also reduced hospitalizations for heart failure (HR, 0.59; 95% CI, 0.43-0.80) and infection (HR, 0.65; 95% CI, 0.52-0.82). This cardiovascular benefit of febuxostat was consistently observed in the TriNetX dataset. Moreover, subgroup analysis revealed that febuxostat was better in reducing death and heart failure events than allopurinol across most of the subgroups.
Conclusions: Febuxostat may confer cardioprotective effects in patients with advanced chronic kidney disease compared with allopurinol, thereby potentially useful in reducing cardiovascular risks in this high-risk population.
期刊介绍：
The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.
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