For a study, researchers wanted to assess the safety and efficacy of febuxostat versus allopurinol in the treatment of chronic gout. For the treatment of chronic gout, the researchers conducted a comprehensive review and meta-analysis of randomized and non-randomized controlled studies that compared oral febuxostat to oral allopurinol. 2 reviewers chose studies, assessed research quality, and extracted data separately. Random effects were used to compute risk ratios (RR), which were then reported with 95% confidence ranges (CI). 7 research and 25 related papers were selected from 1,076 potentially relevant citations; 5 studies were finally included in the analysis. When compared to allopurinol, Febuxostat did not diminish the risk of gout flares (RR=1.16, 95% CI=1.03–1.30, I2=44%). When compared to allopurinol, the risk of any adverse event was lower in febuxostat recipients (RR=0.94, 95% CI=0.90–0.99, I2=13%). Patients who received febuxostat were more likely than those who received allopurinol to attain a serum uric acid level of less than 6 mg/dl (RR=1.56, 95% CI=1.22–2.00, I2=92%). A subgroup analysis revealed no significant difference in the risk of gout flares between high- and low-dose febuxostat. Despite the fact that febuxostat was linked to a higher likelihood of meeting a goal blood uric acid level of less than 6 mg/dl, the pooled findings showed significant heterogeneity. For clinically meaningful outcomes, there was no indication that febuxostat is superior to allopurinol. Due to its increased cost, febuxostat should not be used as a first-line treatment for persistent gout.
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