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• W4290948809 abstract "Background Gout is associated with an increased risk of cardiovascular (CV) disease. Objectives To update comparative CV safety of febuxostat versus allopurinol among patients with gout Methods Using the 2011-2019 Korea National Health Insurance database, we conducted a cohort study comparing gout patients initiating febuxostat versus allopurinol, with study participants matched on a propensity score (PS) for>60 covariates at a 1:1 ratio. The primary outcome was composite CV outcome of myocardial infarction, coronary revascularization, and stroke. Secondary outcomes were CV and all-cause mortalities in addition to individual components of the primary outcome. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), comparing febuxostat versus allopurinol initiators. Results We included 160,930 febuxostat users PS-matched on 160,930 allopurinol users (mean age 59.3 years, 79.6% male). During a mean follow-up of 250 days, the incidence rate of the primary outcome was 2.27 and 2.06 per 100 person-years for allopurinol and febuxostat users respectively, with the PS-matched HR [95% CI] of 1.03 [0.95-1.12]. Analysis on secondary outcomes also showed a similar result except for all-cause mortality with a significantly reduced risk among febuxostat users with a PS-matched HR [95% CI] of 0.84 [0.78-0.91] (Table 1). Table 1. Comparative cardiovascular safety between febuxostat and allopurinol Febuxostat N = 160,930 Allopurinol (Ref) N= 160,930 HR (95% CI) Events PY a IR [95% CI] Events PY a IR(95% CI] Composite CV endpoint 2635 128,193 2.06 [1.98-2.13] 2,099 92,512 2.27 [2.17-2.37] 1.03 [0.95-1.12] MI 468 129,873 0.36 [0.33-0.39] 341 93,808 0.36 [0.33-0.40] 1.13 [0.91-1.39] Coronary revascularization 1085 129,233 0.84 [0.79-0.89] 856 93,293 0.92 [0.86-0.98] 1.10 [0.96-1.26] Stroke or TIA 1490 129,163 1.15 [1.10-1.21] 1,187 93,252 1.27 [1.20-1.35] 0.99 [0.90-1.10] Death 2558 130,176 1.97 [1.89-2.04] 2,201 94,007 2.34 [2.24-2.44] 0.84 [0.78-0.91] a IR is per 100 person-years. IR=incidence rate, HR=hazard ratio, CI=confidence interval, MI=myocardial infarction, PY=person-years, TIA=transient ischemic attack Conclusion This large population-based cohort study showed a similar CV safety profile between febuxostat and allopurinol users but found a 16% reduced all-cause mortality among febuxostat users compared to allopurinol, primarily derived from non-CV death reduction. Disclosure of Interests None declared" @default.
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• W4290948809 date "2022-05-23" @default.
• W4290948809 modified "2023-09-25" @default.
• W4290948809 title "POS0282 UPDATE ON COMPARATIVE CARDIOVASCULAR SAFETY OF FEBUXOSTAT VERSUS ALLOPURINOL AMONG PATIENTS WITH GOUT" @default.
• W4290948809 doi "https://doi.org/10.1136/annrheumdis-2022-eular.2910" @default.
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