Abstract
The safety of newer xanthine oxidase inhibitor-febuxostat comparing to allopurinol remains unclear. To compare the risks of allopurinol- and febuxostat-hypersensitivity and cardiovascular diseases (CVD) in Asians, we conducted a population-based cohort study enrolling patients receiving allopurinol or febuxostat from Chang Gung Memorial Hospital Health System across Taiwan during 2012-2016 and further performed a meta-analysis incorporating two recent studies. Among the 61,539 users, a corresponding 12,007 and 5,680 patients were identified as new users. The overall incidence of febuxostat-hypersensitivity was significantly lower than allopurinol-hypersensitivity (0.2v.s.2.7 per 1000 new users, P<0.001). There were 33 allopurinol-hypersensitivity (including 18 severe cutaneous adverse drug reactions) and only one patient developed febuxostat-maculopapular exanthema. Moreover, febuxostat was not statistically increased risk of CVD (HR,1.16; P=0.152) and related death (HR,1.49; P=0.496) compared to allopurinol. The result of meta-analysis also showed consistent result. In conclusion, the incidence and severity of febuxostat-hypersensitivity are lower than with allopurinol. Febuxostat didn't show an increased risk of CVD and related death. This article is protected by copyright. All rights reserved.
| Original language | English |
|---|---|
| Journal | Clinical Pharmacology and Therapeutics |
| DOIs | |
| Publication status | E-pub ahead of print - Jan 28 2019 |
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Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians : A population-based cohort study and meta-analysis. / Chen, Chi-Hua; Chen, Chun-Bing; Chang, Chee Jen; Lin, Yu Jr; Wang, Chuang-Wei; Chi, Ching-Chi; Lu, Chun-Wei; Chen, Wei-Ti; Pan, Ren-You; Su, Shih-Chi; Hsu, Lung-An; Chang, Ya-Ching; Yu, Kuang-Hui; Wu, Yeong-Jian Jan; Lin, Ko-Ming; Hung, Shuen-Iu; Chen, Shin-Ming; Chung, Wen-Hung.
In: Clinical Pharmacology and Therapeutics, 28.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians
T2 - A population-based cohort study and meta-analysis
AU - Chen, Chi-Hua
AU - Chen, Chun-Bing
AU - Chang, Chee Jen
AU - Lin, Yu Jr
AU - Wang, Chuang-Wei
AU - Chi, Ching-Chi
AU - Lu, Chun-Wei
AU - Chen, Wei-Ti
AU - Pan, Ren-You
AU - Su, Shih-Chi
AU - Hsu, Lung-An
AU - Chang, Ya-Ching
AU - Yu, Kuang-Hui
AU - Wu, Yeong-Jian Jan
AU - Lin, Ko-Ming
AU - Hung, Shuen-Iu
AU - Chen, Shin-Ming
AU - Chung, Wen-Hung
N1 - This article is protected by copyright. All rights reserved.
PY - 2019/1/28
Y1 - 2019/1/28
N2 - The safety of newer xanthine oxidase inhibitor-febuxostat comparing to allopurinol remains unclear. To compare the risks of allopurinol- and febuxostat-hypersensitivity and cardiovascular diseases (CVD) in Asians, we conducted a population-based cohort study enrolling patients receiving allopurinol or febuxostat from Chang Gung Memorial Hospital Health System across Taiwan during 2012-2016 and further performed a meta-analysis incorporating two recent studies. Among the 61,539 users, a corresponding 12,007 and 5,680 patients were identified as new users. The overall incidence of febuxostat-hypersensitivity was significantly lower than allopurinol-hypersensitivity (0.2v.s.2.7 per 1000 new users, P<0.001). There were 33 allopurinol-hypersensitivity (including 18 severe cutaneous adverse drug reactions) and only one patient developed febuxostat-maculopapular exanthema. Moreover, febuxostat was not statistically increased risk of CVD (HR,1.16; P=0.152) and related death (HR,1.49; P=0.496) compared to allopurinol. The result of meta-analysis also showed consistent result. In conclusion, the incidence and severity of febuxostat-hypersensitivity are lower than with allopurinol. Febuxostat didn't show an increased risk of CVD and related death. This article is protected by copyright. All rights reserved.
AB - The safety of newer xanthine oxidase inhibitor-febuxostat comparing to allopurinol remains unclear. To compare the risks of allopurinol- and febuxostat-hypersensitivity and cardiovascular diseases (CVD) in Asians, we conducted a population-based cohort study enrolling patients receiving allopurinol or febuxostat from Chang Gung Memorial Hospital Health System across Taiwan during 2012-2016 and further performed a meta-analysis incorporating two recent studies. Among the 61,539 users, a corresponding 12,007 and 5,680 patients were identified as new users. The overall incidence of febuxostat-hypersensitivity was significantly lower than allopurinol-hypersensitivity (0.2v.s.2.7 per 1000 new users, P<0.001). There were 33 allopurinol-hypersensitivity (including 18 severe cutaneous adverse drug reactions) and only one patient developed febuxostat-maculopapular exanthema. Moreover, febuxostat was not statistically increased risk of CVD (HR,1.16; P=0.152) and related death (HR,1.49; P=0.496) compared to allopurinol. The result of meta-analysis also showed consistent result. In conclusion, the incidence and severity of febuxostat-hypersensitivity are lower than with allopurinol. Febuxostat didn't show an increased risk of CVD and related death. This article is protected by copyright. All rights reserved.
U2 - 10.1002/cpt.1377
DO - 10.1002/cpt.1377
M3 - Article
C2 - 30690722
JO - Clinical Pharmacology and Therapeutics
JF - Clinical Pharmacology and Therapeutics
SN - 0009-9236
ER -