Summary of findings 6. Febuxostat 120 mg/day versus allopurinol.
| Febuxostat 120 mg/day compared to allopurinol for chronic gout | ||||||
| Patient or population: patients with chronic gout Settings: Primary care Intervention: Febuxostat 120 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 120 mg/day | |||||
| Incidence of gout flares Follow‐up: 28 & 52 weeks | 420 per 1000 | 542 per 1000 (365 to 802) | RR 1.3 (0.87 to 1.9) | 986 (2 studies) | ++++ high | Not statistically significant. |
| Serum uric acid <6.0 mg/dL at final visit Follow‐up: 28 & 52 weeks | 384 per 1000 | 829 per 1000 (733 to 941) | RR 2.2 (1.9 to 2.5) | 880 (2 studies) | +++O moderate1 | NNT= 3 (95%CI 2 to 3); ARR = 44% (95% CI 38 to 50%); RRR = NE. |
| 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: 28 & 52 weeks | 50 per 1000 | 58 per 1000 (35 to 96) | RR 1.2 (0.70 to 1.93) | 1041 (3 studies) | ++++ high | Not statistically significant. |
|
Discontinuations due to adverse events Follow‐up: 28 & 52 weeks |
50 per 1000 | 78 per 1000 (24 to 251) | RR 1.6 (0.49 to 5.0) | 1041 (3 studies) | ++++ high | 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; ARR: Absolute risk reduction; ARI: Absolute risk increase; RRR: Relative risk reduction; RRI: Relative risk increase; 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. | ||||||
| 1 Outcome is a substitute measurement (surrogate endpoint). | ||||||