Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis
| Autor: | John Belcher, Charles A. Hay, Christian D Mallen, James A. Prior, Edward Roddy |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male musculoskeletal diseases congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Time Factors Gout Allopurinol MEDLINE Cochrane Library Q1 Risk Assessment Gout Suppressants 03 medical and health sciences 0302 clinical medicine Rheumatology Risk Factors Cause of Death Internal medicine medicine Humans Aged 030203 arthritis & rheumatology business.industry Hazard ratio R735 nutritional and metabolic diseases Middle Aged medicine.disease R1 Confidence interval Treatment Outcome Meta-analysis Female business RA medicine.drug Cohort study |
| Zdroj: | Arthritis Care & Research. 73:1049-1054 |
| ISSN: | 2151-4658 2151-464X |
| Popis: | OBJECTIVE Urate-lowering therapy (predominantly allopurinol) is highly effective as a treatment for gout, but its wider long-term effects remain unclear. This systematic review and meta-analysis aimed to ascertain the association between mortality and the use of allopurinol in patients with gout. METHOD Medline, Embase, CINAHL, and the Cochrane Library were searched from inception to August 2018. Articles eligible for inclusion used a cohort design and examined cardiovascular or all-cause mortality in patients diagnosed with gout and prescribed allopurinol. Information on study characteristics, design, sample size, and mortality risk estimates were extracted. Article quality was assessed using the Newcastle-Ottawa Scale. Included articles were described in a narrative synthesis and, where possible, risk estimate data were pooled. RESULTS Four articles reported a hazard ratio (HR) risk estimate for all-cause mortality in patients with gout using allopurinol, and 2 of these also reported cardiovascular mortality. Two articles found allopurinol to be protective in patients with gout, 1 found no statistically significant association, and 1 found no statistically significant effect of escalation of allopurinol dosage on all-cause or cardiovascular-related mortality. Data pooling was possible for all-cause mortality and found no association between allopurinol use in patients with gout and all-cause mortality compared to patients with gout not using allopurinol (adjusted HR 0.80 [95% confidence interval 0.60-1.05]). CONCLUSION There was no significant association between all-cause mortality and allopurinol use in people with gout. However, the number of included studies was small, suggesting that further studies are needed. |
| Databáze: | OpenAIRE |
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