不同剂量非布司他与别嘌醇治疗痛风有效性和安全性的Meta分析

A Meta-analysis of the efficacy and safety of different dosages of febuxostat and allopurinol in treatment of gout

目的比较不同剂量非布司他与别嘌醇治疗痛风的有效性和安全性。方法计算机检索Pub Med、Cochrane Library、Em Base、中国知网、万方和维普数据库,收集不同剂量非布司他与别嘌醇治疗痛风的随机对照试验(RCT),提取相关数据,采用Rev Man 5.3软件进行Meta分析。结果共纳入9项RCTs。Meta分析结果显示,随访最后3个月血清尿酸(s UA)持续低于6.0 mg/dl的患者比例、末次随访s UA低于6.0 mg/dl的患者比例非布司他(80、120 mg/d)组均高于别嘌醇组(P<0.05);治疗相关不良事件发生率非布司他(80、120 mg/d)组均低于别嘌醇组(P<0.05)。结论基于当前临床证据,非布司他(80、120 mg/d)相对于别嘌醇治疗痛风能有效降低s UA,减少治疗相关不良事件的发生。

Objective To evaluate the efficacy and safety of different dosages of febuxostat and allopurinol in treat- ment of gout. Methods Retrieved from PubMed, Cochrane library, EmBase, CNKI, Wanfang and VIP database by computer, randomized controlled trials （RCTs） about different dosages of febuxostat versus allopurinol in treatment of gout were collected; and relevant date were extracted. Meta-analysis was drawn by RevMan 5.3 statistical software. Results A total of 9 RCTs were included. It was shown that the proportion of patients who achieved serum urate （sUA） 〈 6.0 mg/dl with last three monthly measur ements and the proportion of patients who achieved sUA 〈 6.0 mg/dl at the final visit in the group of using febuxostat （ 80 mg/d and 120 mg/d） are significantly higher than those in the group of using allopurinol（ P 〈 0.05 ）. For the risk of treat- ment-related adverse events, the group of using febuxostat（80 mg/d and 120 mg/d） are significantly lower than the group of using allopurinol（P 〈 0.05）. Conclusion According to the evidence currently, febuxostat（80 mg/d and 120 mg/d） can reduce sUA and treatment-related adverse events compare with allopurinol.