摘要
Abstract
Objective To evaluate the safety and effectiveness of febuxostat versus allopuinol for the treatment of gout and hyperuricemia. Methods The randomized controlled trials(RCT) were got by searching the database including PubMed, the cochrane library, EMbase, CNKI, SinoMed, VIP, and Wanfang. Two investigator independently screened literature, extrcated data and assessed methodological quality of the studies. Then, the data extracting from RCTs were analyzed by the RevMan 5. 3. Results 7 RCTs were included in total. The result of meta analysis demonstated that, a significantly greater proportion of subjects receiving febuxostat at any dose achieved the primary end point of sUA levels ﹤ 6. 0 mg / dl than subjects receiving allopurinol (45. 8% [ RR = 1. 28, 95% CI: 1. 13 - 1. 46, P = 0. 000 1], 65. 8%[ RR = 1. 73, 95% CI: 1. 61 - 1. 86, P = 0. 000 1], 79. 3% [ RR = 2. 11, 95% CI: 1. 87 - 2. 38, P ﹤ 0. 000 01] ); at the final visit, all febuxostat doses produced significantly greater percent decreases in serum urate levels from baseline compared with allopurinol[febuxostat 40 mg, MD = 1. 82, 95% CI: 0. 39 - 3. 25, P = 0. 01; febuxostat 80 mg, MD = 10. 21, 95% CI: 8. 93 - 11. 49, P ﹤ 0. 000 01; febuxostat 120 mg, MD =18. 33, 95% CI: 16. 23 - 20. 43, P ﹤ 0. 000 01]. The incidence rate of gout in the prophylaxic period of febuxostat 120 mg had statistical ditherence with alloparinol group[ RR = 1. 65, 95% CI: 1. 36 - 2. 02, P ﹤ 0. 000 01]. There were no statistically significant differences in the proportion of subjects requiring treatment for gout flares in febuxostat 80 mg and no prophylaxis peroid of febuxostat 120 mg. Moreover, the adverse events incidence of febuxostat was lower than those of allopurinol[ RR = 0. 95, 95% CI: 0. 91 - 0. 99, P = 0. 03] . The incidence of liver function lesion, serious adverse events were similar in all treatment groups. Conclusion Based on current clinical evidence, the safety and effictiveness of febuxostat were better than allopurinol.关键词
非布司他/别嘌呤醇/痛风/高尿酸血症/系统评价Key words
febuxostat/allopurinol/gout/hyperuricemia/systematic review分类
医药卫生
