{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:57:50Z","timestamp":1790927870364,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Guidelines recommend febuxostat and allopurinol as first\u2010line urate\u2010lowering therapies (ULTs) for gout, yet the cardiovascular safety of febuxostat remains debated, with conflicting randomized trials (CARES, FAST) results and limited real\u2010world evidence in high\u2010risk patients. This target trial emulation study evaluated the long\u2010term cardiovascular safety of febuxostat vs. allopurinol in gout patients with preexisting cardiovascular disease (CVD) using US collaborative electronic health records. We included 7555 propensity\u2010score matched (42 covariates) pairs of adults aged \u2265\u200950\u2009years initiating either febuxostat or allopurinol. The primary outcome of our study was the occurrence of major adverse cardiovascular events (MACE) and the secondary outcome was all\u2010cause mortality. During a 10\u2010year follow\u2010up period (median 1,558\u2009days), MACE risk was comparable (HR: 1.027; 95% CI: 0.978\u20131.079) between the two groups. Febuxostat was associated with modestly increased all\u2010cause mortality (HR: 1.125; 95% CI: 1.039\u20131.217). Risk elevations were consistent across subgroups (White race, males, nonsmokers, etc.). Sensitivity analyses confirmed robustness. Findings suggest cautious febuxostat use in CVD patients, guiding personalized prescribing based on racial and lifestyle factors.<\/jats:p>","DOI":"10.1002\/cpt.70403","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:50:27Z","timestamp":1785502227000},"page":"1057-1067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular Safety of Febuxostat vs. Allopurinol in Gout Patients with Cardiovascular Diseases: A Target Trial Emulation"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9537-4503","authenticated-orcid":false,"given":"Xiuwen","family":"Wang","sequence":"first","affiliation":[{"name":"Center for General Practice Medicine, Department of Rheumatology and Immunology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital Hangzhou Medical College  Hangzhou Zhejiang China"},{"name":"Zhejiang Provincial Key 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