PLoS One. 2026 Jul 31;21(7):e0341242. doi: 10.1371/journal.pone.0341242. eCollection 2026.
ABSTRACT
OBJECTIVE: Abdominal aortic aneurysms (AAA) are potentially life-threatening if they rupture. Xanthine oxidase inhibitors have been suggested to reduce aneurysm growth via urate-lowering and antioxidative mechanisms, though their clinical efficacy remains uncertain. The primary objective of this prospective cohort study was to estimate potential associations between urate-lowering therapies and AAA growth, and secondarily risk of rupture, surgery, all-cause mortality, and major adverse cardiovascular events (MACE), in men aged 65-74.
DESIGN: This population-based cohort study included data from two large cardiovascular screening trials.
METHODS: The two Danish AAA male cohorts contributed with baseline characteristics, including AAA measurements through ultrasound and computed tomography scans. Participants were followed for five years through linkage with the Danish national health registries. Prescription records defined the exposure of urate-lowering therapies, and participants were categorised as users or non-users. Growth rate was examined using multivariate linear regression, and the secondary outcomes were evaluated using Cox regression.
RESULTS: This study included 998 men, of whom 73 (7.3%) were exposed to urate-lowering therapies, with a mean defined daily dose of 0.377 per day. During 3 993 person-years, an insignificant mean difference of 0.28 mm/year (95%CI: -0.96-1.52, p = .66) in AAA growth was observed between users and non-users. No associations between urate-lowering therapies and risk of surgery, rupture, all-cause mortality, or MACE were observed.
CONCLUSION: The use of urate-lowering therapies was not associated with a reduction in AAA progression. These findings do not support a clinically meaningful effect of urate-lowering therapies on aneurysm progression in men with AAA.
PMID:42536696 | DOI:10.1371/journal.pone.0341242