Comparative efficacy and safety of topiroxostat at different dosages in hyperuricemic patients with or without gout: A network meta-analysis of randomized controlled trials.

Abstract

We aimed to assess the relative efficacy and safety of topiroxostat at different dosages in hyperuricemic patients with or without gout. A Bayesian network meta-analysis was performed to combine direct and indirect evidence from randomized controlled trials (RCTs) for evaluating the efficacy and safety of topiroxostat at different dosages, allopurinol 200mg, and placebo in hyperuricemic patients with or without gout. Five RCTs, including 733 patients, fulfilled the inclusion criteria. The number of patients who had achieved a target serum uric acid (sUA) level was significantly higher in the topiroxostat 200mg group than in the placebo group (odds ratio, 1,023; 95% credible interval, 157.7-26,260). Similarly, the number of patients who had achieved the target sUA level was significantly higher with topiroxostat at other dosages and allopurinol than with placebo. The ranking probability based on the surface under the cumulative ranking curve indicated that topiroxostat 200mg was more likely to achieve the best target sUA level, followed by topiroxostat 80mg, allopurinol 200mg, topiroxostat 120mg, topiroxostat 160mg, topiroxostat 60mg, topiroxostat 40mg, and placebo. The frequency of adverse events (AEs) in the placebo group was lower than that in the topiroxostat 40mg, topiroxostat 60mg, and topiroxostat 200mg groups. Topiroxostat 200mg was the most effective treatment option for hyperuricemic patients with or without gout, with an increased risk of AEs.