Category: Federal Forum Posters
Purpose: The Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial revealed that febuxostat had an increased risk of cardiovascular death in patients with nonsteroidal anti-inflammatory drug (NSAID) use or lack of low-dose aspirin use. In June 2018, the Veterans Affairs National Pharmacy Benefits Manager (PBM) released recommendations for febuxostat based upon the CARES trial results. The purpose of this study is to determine if the prescribing practices of febuxostat in patients with cardiovascular disease (or those at high risk) are consistent with PBM recommendations regarding NSAID use, aspirin use, and rheumatology referrals.
Methods: This medication use evaluation is a retrospective chart review. Study participants will be identified by a report from Computerized Patient Record System of patients who have an active prescription for febuxostat between the dates of June 1, 2018 and September 30, 2018 at Central Arkansas Veterans Healthcare System. Patients’ electronic medical records will be reviewed by a pharmacist for inclusion criteria of established cardiovascular disease (defined as history of myocardial infarction, unstable angina, stroke, transient ischemic attack, peripheral vascular disease, microvascular or macrovascular complications of diabetes mellitus, or revascularization procedure) or risk factors for cardiovascular disease (defined as history of hypertension, diabetes mellitus, hyperlipidemia, obesity, or tobacco use). Patients will be excluded if febuxostat is being used for an indication other than gout. The primary outcome is concomitant use of low-dose aspirin as recommended by the Veterans Affairs National PBM. The secondary outcomes are reduction or discontinuation of chronic NSAIDs and utilization of rheumatology referrals. Data will be analyzed using descriptive statistics.
Results: not applicable
Conclusion: not applicable
Lauren Ford– PGY1 Pharmacy Resident, Central Arkansas Veterans Healthcare System, Little Rock, AR