Time-varying cardiovascular risk of febuxostat vs. allopurinol in gout: a one-stage meta-analysis.
Rheumatology (Oxford)Sep 1, 2026
Qige Wei, Yang Shi, Rui Hu et al.
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In 30 seconds
This meta-analysis evaluated the cardiovascular and mortality risks of febuxostat compared to allopurinol in gout patients, using reconstructed individual participant data from four studies (n=19,090). The results indicated significant time-varying effects, with a hazard ratio (HR) for cardiovascular risk of 0.58 (95% CI 0.50-0.68) at 12-24 months, suggesting an initial reduction in risk that diminishes over time.
Key findings
- Cardiovascular risk HRs were 0.58 (95% CI 0.50-0.68) at 12-24 months.
- All-cause mortality HRs were 0.39 (95% CI 0.33-0.45) at 12-24 months.
- Cardiovascular risk HRs increased to 1.09 (95% CI 0.81-1.46) after >48 months.
- All-cause mortality HRs were 1.02 (95% CI 0.77-1.34) after >48 months.
Why it matters
Understanding the time-dependent risks associated with febuxostat versus allopurinol can inform clinicians' decisions regarding long-term management of gout, emphasizing the need for ongoing risk assessment as treatment progresses.