Systematic Evaluation and Meta-analysis of Efficacy and Safety of Different Doses of Febustrinol and Allopurinol in the Treatment of Gout / 中国药房

ABSTRACT

OBJECTIVE： To systematically evaluate the efficacy and safety of febustrin （80 mg/d and 40 mg/d） and allopurinol （300 mg/d） in the treatment of gout， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Embase， Cochrane library， CJFD， Wanfang database and CBM during from database establishment to Mar. 2019， randomized controlled trial （RCT） about efficacy and safety of febustrin 80 mg/d （trial group）， 40 mg/d （observation group） and allopurinol 300 mg/d （control group） in the treatment of gout were collected. After extracting data of clinical studies met inclusion criteria and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was conducted for blood uric acid decrease level， the compliance rate of serum uric acid concentration， incidence of liver dysfunction， incidence of renal dysfunction， incidence of digestive tract reaction and frequency of acute gout attack with Rev Man 5.1 software and Stata 13.0 software. RESULTS： A total of 17 RCTs were included， involving 1 816 patients. Meta-analysis results showed that， the serum uric acid decrease level of patients in trial group [MD＝－70.17， 95％CI （－97.41， －42.93）， P＜0.001] and the compliance rate of serum uric acid concentration [RR＝1.58， 95％CI （1.20， 2.08）， P＝0.001] were higher than observation group； the decrease of serum uric acid level [MD＝－34.68，95％（－61.35， －8.00）， P＝0.01] and the compliance rate of serum uric acid concentration [RR＝1.39，95％CI（1.04，1.85）， P＝0.03] in trial group were significantly higher than control group； the frequency of acute gout attack [RR＝1.54（1.02，2.31）， P＝0.04] in trial group was significantly higher than observation group. The incidence of liver dysfunction in observation group [RR＝0.71，95％CI（0.52，0.99），P＝0.04] was significantly lower than control group， with statistical significance. There was no statistical significance in other indexes among other indexes （P＞0.05）. CONCLUSIONS： Compared with febulostat 40 mg/d and allopurinol 300 mg/d， the efficacy of febulostat 80 mg/d is superior in reducing uric acid levels of gout patients.