{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:48:49Z","timestamp":1789534129881,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["25K20620"],"award-info":[{"award-number":["25K20620"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Hyperuricaemia, a common comorbidity among people with chronic kidney disease, is widely treated with uric acid\u2010lowering agents such as allopurinol and febuxostat. Cardiovascular outcomes of people with chronic kidney disease receiving allopurinol or febuxostat have been controversial. The present study evaluated the risk of cardiovascular events associated with allopurinol or febuxostat treatment in people with chronic kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a new\u2010user active comparator cohort study using a nationwide insurance claims database in Japan. Individuals with an estimated glomerular filtration rate\u2009&lt;\u200960\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      who were newly prescribed allopurinol or febuxostat were included. The primary outcome was a composite of cardiovascular events, including fatal and non\u2010fatal acute myocardial infarction, fatal and non\u2010fatal stroke, and all\u2010cause death. Hazard ratios were estimated using a multivariate Cox regression model. A sensitivity analysis was performed using an inverse probability of treatment weighting (IPTW) Cox regression model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1673 and 7805 individuals were included in the allopurinol and febuxostat treatment groups, respectively. The febuxostat group had a similar incidence of the composite outcome as the allopurinol group (hazard ratio 0.93, 95% confidence interval: 0.79\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.33). The hazard ratio for febuxostat compared with allopurinol treatment did not vary across different estimated glomerular filtration rate levels. The sensitivity analysis using IPTW showed similar results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, no statistically significant difference in the risk of cardiovascular events was observed in people with chronic kidney disease who were newly prescribed febuxostat compared with those newly treated with allopurinol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70149","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:09:57Z","timestamp":1763629797000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Allopurinol Versus Febuxostat Use and the Risk of Cardiovascular Disease in People With Chronic Kidney Disease: A New\u2010User Active Comparator Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"given":"Reiko","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle\u2010Related Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle\u2010Related Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6480-3388","authenticated-orcid":false,"given":"Akira","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle\u2010Related Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4827-6404","authenticated-orcid":false,"given":"Toshimasa","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Metabolic Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kadowaki","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle\u2010Related Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"},{"name":"Department of Diabetes and Metabolic Diseases Graduate School of Medicine, The University of Tokyo  Tokyo Japan"},{"name":"Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology Graduate School of Medicine, The University of Tokyo  Tokyo 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