What is it about?
We asked the question: What is the difference in the risk of new diagnosis of atrial fibrillation (AF; the most common heart rhythm problem) between people who use allopurinol versus febuxostat as their urate-lowering therapy? In propensity-matched analyses (where all other risk factors for atrial fibrillation were matched), compared to allopurinol use, febuxostat use was associated with higher 25% higher risk of AF. This increased risk with febuxostat was seen with 80 mg/day dose, a 62% higher risk of AF (and not with the lower 40mg febuxostat dose), and with 1-180 days of use of febuxostat, a 36% higher risk of AF.
Featured Image
Why is it important?
Physicians should consider the increased AF risk with febuxostat when choosing between allopurinol and febuxostat as the medication for the treatment of gout. This might be even more relevant in people with pre-existing heart disease.
Perspectives
I hope that the article can raise awareness among physicians with regards to a potential benefit of allopurinol when compared to febuxostat, given potential risk with febuxostat, compared to allopurinol, or looking in another way, the potential benefit of allopurinol for the heart compared to febuxostat. I hope you find this article thought-provoking.
Dr. Jasvinder A. Singh
University of Alabama at Birmingham
Read the Original
This page is a summary of: Comparative effectiveness of allopurinol and febuxostat for the risk of atrial fibrillation in the elderly: a propensity-matched analysis of Medicare claims data, European Heart Journal, March 2019, Oxford University Press (OUP),
DOI: 10.1093/eurheartj/ehz154.
You can read the full text:
Contributors
The following have contributed to this page
