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Xie H, Hu N, Pan T, Wu JC, Yu M, Wang DC. Effectiveness and safety of different doses of febuxostat compared with allopurinol in the treatment of hyperuricemia: a meta-analysis of randomized controlled trials. BMC Pharmacol Toxicol 2023; 24:79. [PMID: 38098046 PMCID: PMC10722766 DOI: 10.1186/s40360-023-00723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The prevalence of hyperuricemia has increased steadily with the continuous improvement of living standards. Some studies have reported the clinical effectiveness and safety of different doses of febuxostat in comparison with allopurinol in hyperuricemia treatment, but the sample sizes of the studies have been small, and the results have been inconsistent. We designed this meta-analysis to evaluate the effectiveness and safety of different doses of febuxostat compared with allopurinol in the treatment of hyperuricemia. METHODS The Cochrane Library, Embase, PubMed, Web of Science and ClinicalTrials.gov databases were searched to identify randomized controlled trials (RCTs) comparing the use of febuxostat and allopurinol for the treatment of hyperuricemia. The effectiveness and safety of different doses of febuxostat and allopurinol in treating hyperuricemia were assessed using meta-analysis. RESULTS A total of 11 randomized controlled trials were included in the meta-analysis. The results of the meta-analysis showed that the percentage of patients achieving serum uric acid levels of 6.0 mg/dL or less was higher among patients taking febuxostat (80 mg/d) than among patients taking allopurinol (200-300 mg/d) [RR = 1.79, 95% CI (1.55, 2.08), P < 0.00001]. However, there was no statistically significant difference in the percentage of patients achieving serum uric acid levels of 6.0 mg/dL or less between febuxostat (40 mg/d) and allopurinol (200-300 mg/d) [RR = 1.10, 95% CI (0.93, 1.31), P = 0.25]. There was also no statistically significant difference in the incidence of gout between the febuxostat (40 mg/d) and allopurinol (200-300 mg/d) [RR = 0.97, 95% CI (0.64, 1.49), P = 0.91] or between the febuxostat (80 mg/d) and allopurinol (200-300 mg/d) [RR = 1.13, 95% CI (0.81, 1.58), P = 0.48].No significant difference in the incidence of major adverse reactions as observed between the febuxostat (40 mg/d) and allopurinol (200-300 mg/d) [RR = 1.16; 95% CI (0.43, 3.16), P = 0.77] or between the febuxostat (80 mg/d) and allopurinol (200-300 mg/d) [RR = 1.06; 95% CI (0.79, 1.42), P = 0.70]. The incidence of adverse cardiovascular events did not differ significantly between the febuxostat (40 mg/d) and allopurinol (200-300 mg/d) [RR = 1.30; 95% CI (0.57, 2.95), P = 0.53] or between the febuxostat (80 mg/d) and allopurinol (200-300 mg/d) [RR = 1.79; 95% CI (0.74, 4.32), P = 0.20]. CONCLUSIONS Febuxostat (80 mg/d) was associated with a higher percentage of patients achieving serum uric acid levels of 6.0 mg/dL or less than allopurinol (200-300 mg/d), however, febuxostat (80 mg/d) did not exhibit better efficacy in reducing the incidence of gout. More attention should be devoted to the adverse reactions caused by an increase in febuxostat doses.
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Affiliation(s)
- Hong Xie
- Department of General Medicine, Zigong Fourth People's Hospital, 643000, Zigong, Sichuan, China
| | - Nan Hu
- Department of General Surgery, Zigong Fourth People's Hospital, 19 Tanmulin Road, 643000, Zigong, Sichuan, China
| | - Ting Pan
- Department of General Medicine, Zigong Fourth People's Hospital, 643000, Zigong, Sichuan, China
| | - Jun-Cai Wu
- Department of General Medicine, Zigong Fourth People's Hospital, 643000, Zigong, Sichuan, China
| | - Miao Yu
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, 643000, Zigong, Sichuan, China
| | - Deng-Chao Wang
- Department of General Surgery, Zigong Fourth People's Hospital, 19 Tanmulin Road, 643000, Zigong, Sichuan, China.
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Zheng Z, Si Z, Wang X, Meng R, Wang H, Zhao Z, Lu H, Wang H, Zheng Y, Hu J, He R, Chen Y, Yang Y, Li X, Xue L, Sun J, Wu J. Risk Prediction for the Development of Hyperuricemia: Model Development Using an Occupational Health Examination Dataset. Int J Environ Res Public Health 2023; 20:3411. [PMID: 36834107 PMCID: PMC9967697 DOI: 10.3390/ijerph20043411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Hyperuricemia has become the second most common metabolic disease in China after diabetes, and the disease burden is not optimistic. METHODS We used the method of retrospective cohort studies, a baseline survey completed from January to September 2017, and a follow-up survey completed from March to September 2019. A group of 2992 steelworkers was used as the study population. Three models of Logistic regression, CNN, and XG Boost were established to predict HUA incidence in steelworkers, respectively. The predictive effects of the three models were evaluated in terms of discrimination, calibration, and clinical applicability. RESULTS The training set results show that the accuracy of the Logistic regression, CNN, and XG Boost models was 84.4, 86.8, and 86.6, sensitivity was 68.4, 72.3, and 81.5, specificity was 82.0, 85.7, and 86.8, the area under the ROC curve was 0.734, 0.724, and 0.806, and Brier score was 0.121, 0.194, and 0.095, respectively. The XG Boost model effect evaluation index was better than the other two models, and similar results were obtained in the validation set. In terms of clinical applicability, the XG Boost model had higher clinical applicability than the Logistic regression and CNN models. CONCLUSION The prediction effect of the XG Boost model was better than the CNN and Logistic regression models and was suitable for the prediction of HUA onset risk in steelworkers.
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Affiliation(s)
- Ziwei Zheng
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Zhikang Si
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Xuelin Wang
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Rui Meng
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Hui Wang
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Zekun Zhao
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Haipeng Lu
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Huan Wang
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Yizhan Zheng
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jiaqi Hu
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Runhui He
- College of Science, North China University of Science and Technology, Tangshan 063210, China
| | - Yuanyu Chen
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Yongzhong Yang
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Xiaoming Li
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Ling Xue
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jian Sun
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jianhui Wu
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
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