Сравнительная эффективность и безопасность терапии по снижению уровня уратов для лечения гиперурикемии
Аннотация
Распространенность гиперурикемии и подагры возрастает, но до сих пор не проведена оценка сравнительной эффективности и безопасности различных методов их лечения. Целью сетевого метаанализа было сравнение эффективности и безопасности различных методов лечения гиперурикемии. Систематическому анализу были подвергнуты 15 рандомизированных контролируемых исследований (РКИ) с участием 7246 пациентов в период до января 2016 г., в которых сравнивали эффективность различных препаратов, снижающих уровень мочевой кислоты (МК) (аллопуринол, бензбромарон, фебуксостат, пеглотиказу и пробенецид) при гиперурикемии. Эффективность и безопасность лекарственных средств (как исходы данного анализа) оценивались по достижению целевого уровня МК в сыворотке и возникновению нежелательных явлений (НЯ), независимо от их наличия. Эффективность (ее показатели, выраженные как отношения шансов (ОШ) и 95% доверительные интервалы (ДИ)) и безопасность лекарственных средств оценивались по совокупным вероятностям градации. Результаты показывают, что фебуксостат, бензбромарон, пробенецид, пеглотиказа и аллопуринол были очень эффективными в лечении гиперурикемии по сравнению с плацебо. Фебуксостат обладал большей эффективностью и безопасностью по сравнению с другими препаратами. Кроме того, фебуксостат 120 мг при приеме 1 р/сут был более эффективным при снижении уровня уратов (ОШ: 0,17, 95% ДИ: 0,12–0,24) и безопаснее (OR: 0,72, 95% ДИ: 0,56–0,91), чем аллопуринол.
По материалам статьи Comparative efcacy and safety of urate-lowering therapy for the treatment of hyperuricemia: a systematic review and network meta-analysis. Shu Li, Hongxi Yang, Yanan Guo, Fengjiang Wei, Xilin Yang, Daiqing Li, Mingzhen Li, Weili Xu, Weidong Li, Li Sun, Ying Gao & Yaogang Wang
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