Comparative efcacy and safety of urate-lowering therapy for the treatment of hyperuricemia

The prevalence of hyperuricemia and gout is increasing, but comparative efficacy and safety of various treatment methods have not yet been evaluated. The network meta-analysis was aimed at comparing the efficacy and safety of various treatments for hyperuricemia. The systemic review included 15 randomized controlled trials (RCTs) involving 7246 patients during the period until January 2016 aimed at comparing the efficacy of various drugs that lower the level of uric acid (UA) (allopurinol, benzbromarone, febuxostat, pegloticase and probenecid) in hyperuricemia. The efficacy and safety of drugs (as the outcomes of this analysis) were evaluated after reaching the target level of UA in the serum and the occurrence of adverse events (AEs) regardless of their presence. Efficacy (its values expressed as odds ratios (OR) and 95% confidence intervals (CIs)), and drug safety were assessed by cumulative gradation probabilities. The results show that febuxostat, benzbromarone, probenecid, pegloticase and allopurinol were very effective for the treatment of hyperuricemia compared with placebo. Febuxostat was more effective and safer than other drugs. In addition, febuxostat 120 mg QD was more effective in lowering urate levels (OR: 0.17, 95% CI: 0.120.24) and safer (OR: 0.72, 95% CI: 0.56-0.91) than allopurinol