CARES study: cardiovascular safety of febuxostat

M.S. Eliseev, A.M. Novikova

Research Institute of Rheumatology named after V.A. Nasonova, Moscow

CARES (Gout and Cardiovascular Morbidities) study, data of which were published in 2018, served as the basis for adjustment the basic recommendations of the American College of Rheumatology (ACR) for the treatment of gout due to the fact that the incidence of cardiovascular mortality was significantly higher in the group receiving febuxostat (4.3%) versus the allopurinol group (3.2%) (p = 0.03). However, it is not possible to categorically accept the results of the study, given the number of serious methodological discrepancies, such as cancellation of the drug therapy in more than 50% of patients, termination of follow-up in 45% of patients, the initially prevailing number of patients with cardiovascular pathology in the febuxostat group, dosage inadequacy of medications taken, lack of information about the incidence and duration of arthritis and data on the use of non-steroidal anti-in flammatory drugs. Taking into account the described drawbacks and new researches results, the association of febuxostat administration with a high risk of cardiovascular mortality is premature and requires comparative studies without these drawbacks, including in patients with asymptomatic hyperuricemia, since in this case, it is possible to use placebo-control.

Keywords: cardiovascular diseases, febuxostat, allopurinol, hyperuricemia.

For citation: Eliseev M.S., Novikova A.M. CARES study: cardiovascular safety of febuxostat. RMJ. 2020;7:39–42.