mdedge.com
Contrary to expectation in this 10-year observational study, all-cause, cardiovascular and cancer mortality increased slightly (about 8%) with Allopurinol dose escalation, especially in the first 2 years; albeit the increase was not statistically significant.
But less than a third of the dose-escalators achieved serum uric acid target of <6 mg%. Among these, there was a 7% reduction in cardiovascular mortality compared to case-matched non-escalators.
CARES Study- More CV Deaths with Febuxostat
Without a placebo arm, is Allopurinol better, or Febuxostat worse, for all-cause (mainly cardiac) mortality?
Implications of the cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular morbidities (CARES) trial and associated FDA public safety alert
Public Citizen Pressures FDA to Pull Febuxostat
Effects of allopurinol versus febuxostat on cardiovascular risk in korean patients with gout: a nation-wide cohort study
ard.bmj.com
“In this large Korean population-based cohort study, CV risks appear to be numerically, but not statistically significantly, elevated among allopurinol initiators compared to febuxostat initiators.”
Febuxostat for Cerebral and CaRdiorenovascular Events PrEvEntion StuDy (FREED)
FREED from CARES!
