In this study of total 13,997 gout patients, no benefit of XOI use on risk of major cardiovascular events or all-cause mortality was found; febuxostat had a similar risk of cardiovascular events and all-cause mortality than with allopurinol; concomitant colchicine use decrease all-cause mortality risk  among XOI users and its > 3 days use significantly reduces hospitalizations due to heart failure.

This retrospective cohort study compared the major adverse cardiovascular events (MACE) and all-cause mortality between xanthine oxidase inhibitors (XOIs) and non-XOI users, and allopurinol and febuxostat users.

The propensity scores was used to match XOI users 1:1 to XOI non-users in gout patients under consideration. Febuxostat users were matched 1:3 to allopurinol users. As per colchicine use, the subgroup analyses were directed.

Overall, 3607 (25.8%) were XOI users and 10 390 (74.2%) were XOI non-users out of total 13 997 eligible gout patients. XOI users (n = 3607) showed similar incidence of MACE and all-cause mortality as compared to non-users (n = 3607), Table 1.

Febuxostat (n = 276) users portrayed a similar risk of MACE than with allopurinol users with an inclination towards lower heart failure-related hospitalizations risk, Table 2.

The use of concomitant colchicine decreased the risk for all-cause mortality in XOI users. 

A similar risk profile of MACE and all-cause mortality was observed XOI users and non-users in gout patients. Paitents using febuxostat had similar MACE and all-cause mortality risks nevertheless lower heart failure-related hospitalizations as compared to allopurinol.