Response: Re: To Treat or Not to Treat? Effect of Urate-Lowering Therapy on Renal Function, Blood Pressure and Safety in Patients with Asymptomatic Hyperuricemia

[摘要] To the Editor: We would like to thank Dr. Kawada for hisinterest in our article. He mentioned the meta-analysis byGao et al, in which a better safety outcome for febuxostatcompared with allopurinol was observed in gout patientsin terms of urgent coronary revascularization and stroke.1In our network meta-analysis (NMA),2 trials reporting cardiovascular events all used febuxostat as the treatment, sowe could not compare its cardiovascular effect to allopurinol in patients with asymptomatic hyperuricemia. Besides,the cardiovascular events in our analysis included severaltypes of cardiovascular diseases, such as heart failure andnon-fatal myocardial infarction. Our study, nevertheless,found that patients using febuxostat had significantly lowerdiastolic blood pressure than those using placebo, indicating that febuxostat has a cardiovascular protective effect.Similar effects on diastolic blood pressure were notobserved in the allopurinol group.We need more randomized controlled trials to clarify this issue.

[学科分类] 过敏症与临床免疫学