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Effect of Febuxostat on Clinical Outcomes in Patients with Hyperuricemia and Cardiovascular Disease

Authors :
Cardiorenovascular Events Prevention Study (Freed) investigators
Yoshihiko Saito
Hideaki Jinnouchi
Naoto Yokota
Eiichi Tokutake
Hisao Mori
Yusuke Ohya
Kazuaki Uchiyama
Masaaki Konishi
Hisao Ogawa
Masahiro Sugawara
Kazuo Kimura
Kenichi Tsujita
Masako Waki
Shinya Hiramitsu
Takahiro Hayashi
Yutaka Wakasa
Sunao Kojima
Kunihiko Matsui
Ichiro Hisatome
Naoki Kawai
Hirokazu Kakuda
Source :
SSRN Electronic Journal.
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

We previously reported on the FREED study, which found that febuxostat reduced the risk of adverse clinical outcome in patients with asymptomatic hyperuricemia without gout. We have now investigated outcomes in subgroups of FREED patients with and without a history of cardiovascular disease (CVD).We performed a post hoc subgroup analysis of 1070 patients randomized to the febuxostat or non-febuxostat group and followed for 36 months.At baseline, 234 patients (21.9%) had a history of CVD, including 86 patients with stroke (36.8%), 90 with coronary artery disease (38.5%), 74 with heart failure (31.6%), and 25 with vascular disease (10.7%). The risk for the primary composite endpoint, i.e., cerebral, cardiovascular, and renal events and all deaths, was higher in patients with CVD than in those without CVD (34.2% vs 23.7%; p 0.001). Treatment with febuxostat lowered rates of the primary composite endpoint in patients with CVD (hazard ratio [HR] 0.601, 95% CI 0.384 to 0.940, p = 0.026), and these effects were consistently observed in subgroups with and without CVD (p = 0.227 for treatment by subgroup interaction). Furthermore, in the subgroup with CVD, all-cause mortality was significantly lower in the febuxostat group than in the non-febuxostat group (HR 0.160, 95% CI 0.047 to 0.547, p = 0.004), with a significant subgroup interaction (p = 0.007 for treatment by subgroup interaction).In patients with asymptomatic hyperuricemia without gout, febuxostat reduces the risk of the composite of cerebral, cardiovascular, and renal events and death in the secondary prevention setting.

Details

ISSN :
15565068
Database :
OpenAIRE
Journal :
SSRN Electronic Journal
Accession number :
edsair.doi.dedup.....518375571f6408e857bf07b97677a3fe
Full Text :
https://doi.org/10.2139/ssrn.3927636