Efficacy and safety of urate‐lowering treatments in patients with hyperuricemia: A comprehensive network meta‐analysis of randomized controlled trials

What is known and objective Hyperuricemia (HUA) and gout are considerable public health problems because of their increasing incidence and interactions with other diseases. We aimed to evaluate the efficacy and safety of urate‐lowering therapies (ULTs) for patients. Methods A systematic literature r...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical pharmacy and therapeutics 2020-08, Vol.45 (4), p.729-742
Main Authors: Sun, Shan‐Shan, Zhang, Dong‐Hu, Shi, Yue, Lin, Cheng‐Jiang, Lin, Jian‐Yang
Format: Article
Language:English
Subjects:
Allopurinol
Allopurinol - therapeutic use
Bayes Theorem
Bayesian analysis
Bayesian network meta‐analysis
Clinical trials
Febuxostat - therapeutic use
Gout
Gout - drug therapy
Gout - metabolism
Gout Suppressants - adverse effects
Gout Suppressants - therapeutic use
Humans
Hyperuricemia
Hyperuricemia - drug therapy
Hyperuricemia - metabolism
Literature reviews
Markov chains
Meta-analysis
Monte Carlo simulation
Network Meta-Analysis
Public health
Randomized Controlled Trials as Topic
Safety
urate‐lowering therapy
Uric acid
Uric Acid - metabolism
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:What is known and objective Hyperuricemia (HUA) and gout are considerable public health problems because of their increasing incidence and interactions with other diseases. We aimed to evaluate the efficacy and safety of urate‐lowering therapies (ULTs) for patients. Methods A systematic literature review was conducted, and a network meta‐analysis was performed on the included studies using the Markov Chain Monte Carlo simulation method and a Bayesian statistical framework. We calculated surface under the cumulative ranking curve (SUCRA) values and performed clustered ranking to combine the efficacy and safety results. Results Twenty‐two randomized controlled studies were identified for the efficacy analysis, and 20 studies were identified for the safety analysis. Compared with the placebo, the ULTs were efficient and safe. Febuxostat 120 mg/d and allopurinol 200 mg/d had the highest SUCRA scores for efficacy and safety, respectively. Clustered ranking results showed that febuxostat 120 mg/d was the best in terms of efficacy and safety, topiroxostat 120/160 mg/d was similar to febuxostat 80 mg/d in terms of efficacy but safer, and allopurinol was not inferior to topiroxostat. What is new and conclusion Febuxostat had the best efficacy and safety results among the tested agents, and topiroxostat and allopurinol appeared to have fewer adverse events. We calculated surface under the cumulative ranking curve (SUCRA) values using the Markov Chain Monte Carlo simulation method and a Bayesian statistical framework and performed clustered ranking to combine the efficacy and safety results for evaluating ULTs for HUA patients.
ISSN:0269-4727
1365-2710
DOI:10.1111/jcpt.13156