Uric acid (UA)‐lowering drug compared to placebo for hyperuricemia in hypertensive patients

Patient or population: hyperuricemia in hypertensive patients
Setting: several sites in the USA
Intervention: uric acid (UA)‐lowering drug
Comparison: placebo

24h‐Systolic Blood Pressure

MD ‐6.2 (‐12.8, 0.5)

229
(3 RCTs)

⊕⊕⊝⊝
LOW ^{1 2}

24h‐Diastolic Blood Pressure

MD ‐3.9 (‐9.2, 1.4)

229
(3 RCTs)

⊕⊕⊝⊝
LOW ^{1 2}

Clinic Systolic Blood Pressure

MD ‐8.4 (‐15.2, ‐1.6)

120
(2 RCTs)

⊕⊕⊝⊝
LOW ^{1 2}

Clinic Diastolic Blood Pressure

MD ‐6.5 (‐13.6, 0.7)

120
(2 RCTs)

⊕⊕⊝⊝
LOW ^{1 2}

Serum uric acid

MD ‐3.1 (‐3.8, ‐2.4)

223
(3 RCTs)

⊕⊕⊕⊕
HIGH

Withdrawals due to adverse effects

RR 1.86
(0.43 to 8.10)

241
(3 RCTs)

⊕⊝⊝⊝
VERY LOW ^{1 3 4}

NCT01496469 reported only one withdrawal due to adverse events. However, four adverse events were described in the febuxostat group, which might be drug‐related. Therefore, we decided to include all four cases in the assessment of RR for this study.

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; RCT: Randomized controlled trial.

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect