Summary of findings 5. Febuxostat 80 mg/day versus allopurinol.
| Febuxostat 80 mg/day compared to allopurinol for chronic gout | ||||||
| Patient or population: patients with chronic gout Settings: Primary care Intervention: Febuxostat 80 mg/day Comparison: Allopurinol | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Allopurinol | Febuxostat 80 mg/day | |||||
| Incidence of gout flares Follow‐up: 8, 26, & 52 weeks | 204 per 1000 | 228 per 1000 (200 to 259) | RR 1.1 (0.98 to 1.3) | 2325 (3 studies) | ++++ high | Not statistically significant. |
| Serum uric acid <6.0 mg/dL at final visit Follow‐up: 8, 26, & 52 weeks | 398 per 1000 | 716 per 1000 (617 to 832) | RR 1.8 (1.6 to 2.2) | 2193 (3 studies) | ++OO low1,2 | NNT= 3 (95%CI 3 to 5); ATB = 29% (95% CI 25 to 33%); RRR = 73%. |
| Pain | See comment | See comment | See comment | See comment | See comment | Not assessed |
| Patient global assessment | See comment | See comment | See comment | See comment | See comment | Not assessed |
| Health Related Quality of Life | See comment | See comment | See comment | See comment | See comment | Not assessed |
| Serious Adverse Events Follow‐up: 24. 28. & 52 weeks | 50 per 1000 | 45 per 1000 (17 to 122) | RR 0.91 (0.34 to 2.4) | 1044 (3 studies) | +++O moderate1,4 | Not statistically significant. |
| Discontinuations due to adverse events Follow‐up: 24. 28. & 52 weeks | 50 per 1000 | 65 per 1000 (39 to 107) | RR 1.3 (0.79 to 2.1) | 1044 (3 studies) | +++O moderate4 | Not statistically significant. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; NNT: Number needed to treat; ATB: Absolute treatment benefit; RRR: Relative risk reduction; NE: Not estimable. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
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1 Heterogeneity exists across the studies
2 Outcome is a substitute measurement (surrogate endpoint).
3 Pooled estimates are from 2 studies (Schumacher 2008 and Becker 2005a) 4 High risk of bias in 1 item (intention to treat was not performed) | ||||||