Time-varying cardiovascular risk of febuxostat vs. allopurinol in gout: a one-stage meta-analysis
Authors' conclusion
The cardiovascular and mortality risk of febuxostat relative to allopurinol is time-dependent, showing a significant early reduction that attenuates over time.
Study context
- Population
- Patients with gout
- Participants
- 19,090 patients4 studies
- Comparison
- Febuxostat vs allopurinol
- Outcome
- Time-varying cardiovascular risk and all-cause mortality
Methodological detailsone-stage individual participant data meta-analysis, reconstructed individual participant data (IPD) from Kaplan-Meier curves, mixed-effects Cox model with treatment-by-time interaction, pre-specified intervals (0-12, 12-24, 24-48, >48 months), PubMed, Embase and Cochrane Library searched up to November 2025
- One-stage individual participant data meta-analysis
- Reconstructed IPD from Kaplan-Meier curves
- Mixed-effects Cox model with treatment-by-time interaction
- Pre-specified intervals (0-12, 12-24, 24-48, >48 months)
- PubMed, Embase and Cochrane Library searched up to November 2025
Pooled result
As reported in the abstract
CV risk, time-varying HR of febuxostat vs. allopurinol by interval
- Significant time-varying effects
- Hazard ratios (HRs) are febuxostat vs. allopurinol, as the objective states; the result sentences do not name the groups
- Mixed-effects Cox model with treatment-by-time interaction across pre-specified intervals
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Time-varying cardiovascular risk of febuxostat vs. allopurinol in gout: a one-stage meta-analysis. Rheumatology (Oxford). Published 21 August 2026. doi:10.
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