Febuxostat 再戰 allopurinol 的結果，於 2020.11.09 刊登於 Lancet
Study design: prospective, randomised, open-label, blinded-endpoint, non-inferiority trial.
P: 60+ y/o already receiving allopurinol, had 1+ additional CV risk factor (who had MI or stroke in the previous 6 months or who had severe CHF or severe renal impairment were excluded).
I: allopurinol (n=3,065)
C: febuxostat (n=3,063)
O:
- Primary outcome: a composite of hospitalisation for non-fatal MI or biomarker-positive ACS; non-fatal stroke; or CV death.
這次雙方分別只有 6.2% vs. 5.5% 的受試者退出試驗，追蹤年限約為 4 年
各項 CV safety outcome 的分析顯示：相較於 allopurinol，febuxostat 並不會增加心血管事件風險~
相較於 NEJM 2018 年那篇 multicenter, double-blind, noninferiority trial (DOI: 10.1056/NEJMoa1710895) 動輒進半的試驗退出率，我想... 就算 Lancet 這篇是 open-label study，個人仍舊傾向相信 Lancet 這篇的結論~
不過這兩大研究的設計、收的病人類型、風險、febuxostat 的劑量也都不太一樣，在實證的角度上，也是歡迎各自解讀啦~
歡迎大家給我指教~
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32234-0/fulltext
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