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Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis

Hay, Charles A.; Prior, James A.; Belcher, John; Mallen, Christian D.; Roddy, Edward

Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis Thumbnail


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Abstract

ObjectiveUrate‐lowering therapy (predominantly allopurinol) is highly effective as a treatment for gout, but its wider long‐term effects remain unclear. This systematic review and meta‐analysis aimed to ascertain the association between mortality and the use of allopurinol in patients with gout.MethodMedline, Embase, CINAHL, and the Cochrane Library were searched from inception to August 2018. Articles eligible for inclusion used a cohort design and examined cardiovascular or all‐cause mortality in patients diagnosed with gout and prescribed allopurinol. Information on study characteristics, design, sample size, and mortality risk estimates were extracted. Article quality was assessed using the Newcastle‐Ottawa Scale. Included articles were described in a narrative synthesis and, where possible, risk estimate data were pooled.ResultsFour articles reported a hazard ratio (HR) risk estimate for all‐cause mortality in patients with gout using allopurinol, and 2 of these also reported cardiovascular mortality. Two articles found allopurinol to be protective in patients with gout, 1 found no statistically significant association, and 1 found no statistically significant effect of escalation of allopurinol dosage on all‐cause or cardiovascular‐related mortality. Data pooling was possible for all‐cause mortality and found no association between allopurinol use in patients with gout and all‐cause mortality compared to patients with gout not using allopurinol (adjusted HR 0.80 [95% confidence interval 0.60–1.05]).ConclusionThere was no significant association between all‐cause mortality and allopurinol use in people with gout. However, the number of included studies was small, suggesting that further studies are needed.

Citation

Hay, C. A., Prior, J. A., Belcher, J., Mallen, C. D., & Roddy, E. (2021). Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis. Arthritis Care & Research, 73(7), 1049-1054. https://doi.org/10.1002/acr.24205

Journal Article Type Article
Acceptance Date Mar 31, 2020
Online Publication Date Jun 18, 2021
Publication Date 2021-07
Publicly Available Date May 26, 2023
Journal Arthritis Care & Research
Print ISSN 2151-464X
Electronic ISSN 2151-4658
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 73
Issue 7
Pages 1049-1054
DOI https://doi.org/10.1002/acr.24205
Keywords Rheumatology
Publisher URL https://doi.org/10.1002/acr.24205

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