非布司他和苯溴马隆控制痛风的疗效与安全性Meta分析

Efficacy and Safety of Febuxostat and Benzbromarone in Controlling Gout Attacks:a Meta-Analysis

目的比较非布司他与苯溴马隆控制痛风的疗效及安全性。方法在PubMed、EmBase、Medline、Cochrane图书馆、Wanfang与CNKI库内检索非布司他与苯溴马隆的随机双盲试验(randomized controlled trial,RCTs)。由两位工作人员单独完成文章筛查,提取数据后,使用Cochrane系统进行文献的质量评价,使用RevMan5.3.5软件对录入的数据进行Meta分析。结果经过筛选纳入7项RCTs,合计573例研究对象,其中非布司他组300例,苯溴马隆组273例。非布司他组血清尿酸(sUA)达标率(低于360μmol·L^-1)明显高于苯溴马隆组(P<0.00001,RR=1.17,95%CI 1.09~1.25);与苯溴马隆组相比,非布司他组sUA下降幅度高于苯溴马隆组(P<0.05,MD=-22.74,95%CI-39.00^-6.49);2组不良反应发生率相当(OR=0.51,95%CI 0.26~1.00,P=0.05)。结论采用非布司他治疗痛风,更容易改善患者sUA水平。

Objective To compare the efficacy and safety of Febuxostat and Benzbromarone in the control of gout.Methods The PubMed,EmBase,Medline,Cochrane library,Wanfang and CNKI were researched for randomized controlled trials(RCTs)of Febuxostat and Benzbromarone.Literature screening was conducted by two individuals,and the quality of the articles was analyzed using the Cochrane system.The final meta-analysis was performed using RevMan5.3.5.Results Seven RCTs(573 subjects)were included in the meta-analysis,including 300 in Febuxostat group and 273 in Benzbromarone group.The serum uric acid(sUA)compliance rate(lower than 360μmol·L^-1)in Febuxostat group was higher than that in Benzbromarone group(P<0.00001,RR=1.17,95%CI 1.09-1.25).Furthermore,the reduction of sUA concentration in Febuxostat group was greater than that in Benzbromarone group(P<0.05,MD=-22.74,95%CI-39.00--6.49).There was no significant difference in the incidence of adverse reactions between the two groups(OR=0.51,95%CI 0.26-1.00,P=0.05).Conclusion Febuxostat is superior to Benzbromarone for improving sUA level in patients with gout.