論文

国際誌
2020年10月23日

Network Meta-Analysis of Drug Therapies for Lowering Uric Acid and Mortality Risk in Patients with Heart Failure.

Cardiovascular drugs and therapy
  • Satoru Kodama
  • ,
  • Kazuya Fujihara
  • ,
  • Chika Horikawa
  • ,
  • Mayuko Yamada
  • ,
  • Takaaki Sato
  • ,
  • Yuta Yaguchi
  • ,
  • Masahiko Yamamoto
  • ,
  • Masaru Kitazawa
  • ,
  • Yasuhiro Matsubayashi
  • ,
  • Takaho Yamada
  • ,
  • Kenichi Watanabe
  • ,
  • Hirohito Sone

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10557-020-07097-4

PURPOSE: This network meta-analysis aimed to assess the current efficacy of decreasing the uric acid (UA) level with drugs to reduce mortality in patients with heart failure (HF). METHODS: Electronic literature searches using EMBASE and MEDLINE of studies published from 1 Jan 1950 to 26 Dec 2019 were conducted for randomized controlled trials or non-randomized cohort studies that included at least one group of patients who took UA-lowering drugs and with a study outcome of all-cause mortality. A random-effects network meta-analysis was performed within a frequentist framework. Hierarchy of treatments was expressed as the surface under the cumulative ranking curve (SUCRA) value, which is in proportion to mean rank (best is 100%). RESULTS: Nine studies, which included seven different types of groups, were eligible for analysis. The "untreated uricemia" group in which patients had hyperuricemia but without treatment had a significantly higher risk of mortality than the "no uricemia" group in which patients had no hyperuricemia (relative risk (RR)(95% confidence interval (CI), 1.43 (1.08-1.89)). The "start-allo" group wherein patients started to take allopurinol did not have a significantly lower risk of mortality than the "untreated uricemia" group (RR (95% CI), 0.68 (0.45-1.01)). However, in the "start-allo" group the SUCRA value was comparable to that in the "no uricemia" group (SUCRA: 65.4% for "start-allo"; 64.1% for "no uricemia"). CONCLUSIONS: Results suggested that allopurinol therapy was not associated with a significantly improved prognosis in terms of mortality but could potentially counteract the adverse effects associated with longstanding hyperuricemia in HF patients.

リンク情報
DOI
https://doi.org/10.1007/s10557-020-07097-4
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33095357

エクスポート
BibTeX RIS