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

Objective: We aimed to assess the relative efficacy and safety of topiroxostat at different dosages in hyperuricemic patients with or without gout. Materials and methods: 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 200 mg, and placebo in hyperuricemic patients with or without gout. Results: 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 200 mg 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 200 mg was more likely to achieve the best target sUA level, followed by topiroxostat 80 mg, allopurinol 200 mg, topiroxostat 120 mg, topiroxostat 160 mg, topiroxostat 60 mg, topiroxostat 40 mg, and placebo. The frequency of adverse events (AEs) in the placebo group was lower than that in the topiroxostat 40 mg, topiroxostat 60 mg, and topiroxostat 200 mg groups.Conclusion: Topiroxostat 200 mg was the most effective treatment option for hyperuricemic patients with or without gout, with an increased risk of AEs.