Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study
Abstract Despite recent accumulation on cardiovascular (CV) safety data on xanthine oxidase inhibitors (XOIs) among gout patients, assessment has been largely limited to macro- than micro-vascular disorders, prompting the investigation on the latter outcome. Therefore, we aimed to compare the risk o...
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Nature Portfolio
2025-08-01
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| Online Access: | https://doi.org/10.1038/s41598-025-00551-z |
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| author | Min Jung Kim Jung Yoon Pyo Se Rim Choi Anna Shin Hokyung Choung You-Jung Ha Yun Jong Lee Eun bong Lee Eun Ha Kang |
| author_facet | Min Jung Kim Jung Yoon Pyo Se Rim Choi Anna Shin Hokyung Choung You-Jung Ha Yun Jong Lee Eun bong Lee Eun Ha Kang |
| author_sort | Min Jung Kim |
| collection | DOAJ |
| description | Abstract Despite recent accumulation on cardiovascular (CV) safety data on xanthine oxidase inhibitors (XOIs) among gout patients, assessment has been largely limited to macro- than micro-vascular disorders, prompting the investigation on the latter outcome. Therefore, we aimed to compare the risk of retinal microvascular disorders between allopurinol and febuxostat initiators among gout patients. Using the 2011–2019 Korean National Health Insurance service database, we conducted a cohort study on gout patients initiating allopurinol or febuxostat. The primary outcome was a composite of retinal microvascular disorders. After 1:1 propensity-score (PS) matching in non-diabetic (non-DM) and diabetic (DM) subgroups, pooled and subgroup-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were reported, comparing allopurinol and febuxostat. We included 118,376 PS-matched pairs of febuxostat and allopurinol initiators (mean 57.3 years, 83.7% male; 89,642 pairs in non-DM and 28,734 pairs in DM subgroup). During a mean follow-up of 223 days, the incidence rate per 100 person-years of the primary outcomes was 0.88 among allopurinol users and 0.93 among febuxostat users. The corresponding HR (95% CI) was 0.98 (0.83–1.15). The HR (95% CI) was 0.94 (0.76–1.15) in non-DM subgroup and 1.05 (0.80–1.39) in DM subgroup. The result for DM retinopathy also showed a similar risk (HR 0.86, 95% CI 0.67–1.11). In this large population-based cohort study on patients with gout, we did not find any difference in the risk of retinal microvascular disorders between allopurinol and febuxostat initiators. |
| format | Article |
| id | doaj-art-11ce425b204546269ecf9584bbc5eea7 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-11ce425b204546269ecf9584bbc5eea72025-08-20T03:05:27ZengNature PortfolioScientific Reports2045-23222025-08-011511910.1038/s41598-025-00551-zComparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort studyMin Jung Kim0Jung Yoon Pyo1Se Rim Choi2Anna Shin3Hokyung Choung4You-Jung Ha5Yun Jong Lee6Eun bong Lee7Eun Ha Kang8Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Hospital Boramae Medical CenterDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalDivision of Rheumatology, Department of Internal Medicine, Hanyang University Hospital for Rheumatic DiseasesDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalDepartment of Ophthalmology, Seoul Metropolitan Government-Seoul National University Hospital Boramae Medical CenterDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalDepartment of Internal Medicine, Seoul National University College of MedicineDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalAbstract Despite recent accumulation on cardiovascular (CV) safety data on xanthine oxidase inhibitors (XOIs) among gout patients, assessment has been largely limited to macro- than micro-vascular disorders, prompting the investigation on the latter outcome. Therefore, we aimed to compare the risk of retinal microvascular disorders between allopurinol and febuxostat initiators among gout patients. Using the 2011–2019 Korean National Health Insurance service database, we conducted a cohort study on gout patients initiating allopurinol or febuxostat. The primary outcome was a composite of retinal microvascular disorders. After 1:1 propensity-score (PS) matching in non-diabetic (non-DM) and diabetic (DM) subgroups, pooled and subgroup-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were reported, comparing allopurinol and febuxostat. We included 118,376 PS-matched pairs of febuxostat and allopurinol initiators (mean 57.3 years, 83.7% male; 89,642 pairs in non-DM and 28,734 pairs in DM subgroup). During a mean follow-up of 223 days, the incidence rate per 100 person-years of the primary outcomes was 0.88 among allopurinol users and 0.93 among febuxostat users. The corresponding HR (95% CI) was 0.98 (0.83–1.15). The HR (95% CI) was 0.94 (0.76–1.15) in non-DM subgroup and 1.05 (0.80–1.39) in DM subgroup. The result for DM retinopathy also showed a similar risk (HR 0.86, 95% CI 0.67–1.11). In this large population-based cohort study on patients with gout, we did not find any difference in the risk of retinal microvascular disorders between allopurinol and febuxostat initiators.https://doi.org/10.1038/s41598-025-00551-zFebuxostatAllopurinolRetinal microvascular disorder |
| spellingShingle | Min Jung Kim Jung Yoon Pyo Se Rim Choi Anna Shin Hokyung Choung You-Jung Ha Yun Jong Lee Eun bong Lee Eun Ha Kang Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study Scientific Reports Febuxostat Allopurinol Retinal microvascular disorder |
| title | Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study |
| title_full | Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study |
| title_fullStr | Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study |
| title_full_unstemmed | Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study |
| title_short | Comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol: a population-based cohort study |
| title_sort | comparative risk of retinal microvascular disorders in patients with gout initiating febuxostat versus allopurinol a population based cohort study |
| topic | Febuxostat Allopurinol Retinal microvascular disorder |
| url | https://doi.org/10.1038/s41598-025-00551-z |
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