AI Article Synopsis
- - This study investigates the effects of febuxostat, a medication for hyperuricemia, on cardiovascular health in patients with advanced chronic kidney disease, compared to allopurinol.
- - Conducted over a large cohort of 13,187 patients using data from Taiwan's National Health Insurance Database, results showed that febuxostat significantly reduced all-cause mortality and hospitalizations, particularly for heart failure and infections.
- - The findings suggest that febuxostat might offer cardioprotective benefits for patients with advanced chronic kidney disease, making it a potentially better option than allopurinol for reducing cardiovascular risks.
Article 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) (2012-2020). 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 making it potentially useful in reducing cardiovascular risks in this high-risk population.
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| http://dx.doi.org/10.1016/j.amjmed.2024.09.018 | DOI Listing |
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