Febuxostat vs. Allopurinol in Cardiovascular Safety

Jul 31, 2026 · Published in: Clinical Pharmacology and Therapeutics

Background Information

Cardiovascular comparison of febuxostat and allopurinol in gout patients reveals mixed results.

The cardiovascular safety of febuxostat compared to allopurinol in high-risk gout patients is unclear, with conflicting results from previous studies. Febuxostat showed a comparable risk for major adverse cardiovascular events (MACE) but had a modestly increased all-cause mortality compared to allopurinol. While this study informs gout treatment in patients with cardiovascular disease (CVD), it does not apply to pediatric populations, making it irrelevant to pediatric pharmacy practice. Use febuxostat cautiously in gout patients with CVD, but this study is not relevant to pediatrics.

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Authors: Wang X, Cheng X, Wan YW, Wang Y, Ding S, Ying Z

Citation: Wang X, Cheng X, Wan YW, et al. Cardiovascular Safety of Febuxostat vs. Allopurinol in Gout Patients with Cardiovascular Diseases: A Target Trial Emulation. Clinical pharmacology and therapeutics. 2026. doi:10.1002/cpt.70403

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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