Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians: A population-based cohort study and meta-analysis

Chi-Hua Chen, Chun-Bing Chen, Chee Jen Chang, Yu Jr Lin, Chuang-Wei Wang, Ching-Chi Chi, Chun-Wei Lu, Wei-Ti Chen, Ren-You Pan, Shih-Chi Su, Lung-An Hsu, Ya-Ching Chang, Kuang-Hui Yu, Yeong-Jian Jan Wu, Ko-Ming Lin, Shuen-Iu Hung, Shin-Ming Chen, Wen-Hung Chung

研究成果: 雜誌貢獻文章

摘要

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.
原文英語
期刊Clinical Pharmacology and Therapeutics
DOIs
出版狀態打印前電子出版 - 一月 28 2019

指紋

Allopurinol
Meta-Analysis
Hypersensitivity
Cohort Studies
Population
Cardiovascular Diseases
Therapeutics
Febuxostat
Xanthine Oxidase
Incidence
Exanthema
Drug-Related Side Effects and Adverse Reactions
Taiwan
Safety
Skin
Health

引用此文

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.

於: Clinical Pharmacology and Therapeutics, 28.01.2019.

研究成果: 雜誌貢獻文章

Chen, C-H, Chen, C-B, Chang, CJ, Lin, YJ, Wang, C-W, Chi, C-C, Lu, C-W, Chen, W-T, Pan, R-Y, Su, S-C, Hsu, L-A, Chang, Y-C, Yu, K-H, Wu, Y-JJ, Lin, K-M, Hung, S-I, Chen, S-M & Chung, W-H 2019, 'Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians: A population-based cohort study and meta-analysis', Clinical Pharmacology and Therapeutics. https://doi.org/10.1002/cpt.1377
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. / Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians : A population-based cohort study and meta-analysis. 於: Clinical Pharmacology and Therapeutics. 2019.
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title = "Hypersensitivity and cardiovascular risks related to allopurinol and febuxostat therapy in Asians: A population-based cohort study and meta-analysis",
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.",
author = "Chi-Hua Chen and Chun-Bing Chen and Chang, {Chee Jen} and Lin, {Yu Jr} and Chuang-Wei Wang and Ching-Chi Chi and Chun-Wei Lu and Wei-Ti Chen and Ren-You Pan and Shih-Chi Su and Lung-An Hsu and Ya-Ching Chang and Kuang-Hui Yu and Wu, {Yeong-Jian Jan} and Ko-Ming Lin and Shuen-Iu Hung and Shin-Ming Chen and Wen-Hung Chung",
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doi = "10.1002/cpt.1377",
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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.

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