Cardiovascular outcomes with febuxostat vs allopurinol

The risk for cardiovascular events is thought to be increased amongst people with gout. In a study supported by Takeda (sponsors of the drug febuxostat), researchers compared cardiovascular outcomes with this agent to those observed with the more widely used agent, allopurinol. 6190 patients underwent randomization, received febuxostat or allopurinol, and were followed for a median of 32 months (maximum, 85 months). The trial regimen was discontinued in 56.6% of patients, and a further 45.0% discontinued follow-up. Cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization occurred in 335 patients (10.8%) in the febuxostat group and in 321 patients (10.4%) in the allopurinol group. All-cause and cardiovascular mortality were higher in the febuxostat group than in the allopurinol group (hazard ratio for death from any cause, 1.22 [95% CI, 1.01 to 1.47]; hazard ratio for cardiovascular death, 1.34 [95% CI, 1.03 to 1.73]). More research is needed to further elucidate this potential issue.