Latest & greatest articles for allopurinol

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Top results for allopurinol

1. Effects of Allopurinol on the Progression of Chronic Kidney Disease. (Abstract)

Effects of Allopurinol on the Progression of Chronic Kidney Disease. Elevated serum urate levels are associated with progression of chronic kidney disease. Whether urate-lowering treatment with allopurinol can attenuate the decline of the estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease who are at risk for progression is not known.In this randomized, controlled trial, we randomly assigned adults with stage 3 or 4 chronic kidney disease and no history of gout (...) who had a urinary albumin:creatinine ratio of 265 or higher (with albumin measured in milligrams and creatinine in grams) or an eGFR decrease of at least 3.0 ml per minute per 1.73 m2 of body-surface area in the preceding year to receive allopurinol (100 to 300 mg daily) or placebo. The primary outcome was the change in eGFR from randomization to week 104, calculated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation.Enrollment was stopped because of slow recruitment

2020 NEJM

2. Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes. (Abstract)

Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes. Higher serum urate levels are associated with an increased risk of diabetic kidney disease. Lowering of the serum urate level with allopurinol may slow the decrease in the glomerular filtration rate (GFR) in persons with type 1 diabetes and early-to-moderate diabetic kidney disease.In a double-blind trial, we randomly assigned participants with type 1 diabetes, a serum urate level of at least 4.5 mg per deciliter (...) , an estimated GFR of 40.0 to 99.9 ml per minute per 1.73 m2 of body-surface area, and evidence of diabetic kidney disease to receive allopurinol or placebo. The primary outcome was the baseline-adjusted GFR, as measured with iohexol, after 3 years plus a 2-month washout period. Secondary outcomes included the decrease in the iohexol-based GFR per year and the urinary albumin excretion rate after washout. Safety was also assessed.A total of 267 patients were assigned to receive allopurinol and 263 to receive

2020 NEJM

3. Hypersensitivity reactions with allopurinol and febuxostat: a study using the Medicare claims data (Abstract)

Hypersensitivity reactions with allopurinol and febuxostat: a study using the Medicare claims data To assess the risk of hypersensitivity reactions (HSRs) with allopurinol and febuxostat in a population-based study.We used the 5% Medicare beneficiary sample (≥65 years) from 2006 to 2012 to identify people with a newly filled prescription for allopurinol, febuxostat or colchicine. We used multivariable-adjusted Cox regression analyses to compare the hazard ratio (HR) of incident HSRs (...) with allopurinol or febuxostat use versus colchicine use; separate analyses were done in people exposed to allopurinol. Propensity-matched analyses (5:1) compared hazards with allopurinol versus febuxostat.Crude incidence rates of HSRs were as follows: allopurinol, 23.7; febuxostat, 30.7; and colchicine, 25.6 per 1000 person-years. Compared with colchicine, allopurinol, febuxostat and febuxostat+colchicine were associated with significantly higher HRs of HSRs, 1.32 (95% CI: 1.10 to 1.60) and 1.54 (95% CI: 1.12

2020 EvidenceUpdates

4. Comparative cardiovascular risk in users versus non-users of xanthine oxidase inhibitors and febuxostat versus allopurinol users

Comparative cardiovascular risk in users versus non-users of xanthine oxidase inhibitors and febuxostat versus allopurinol users Comparative Cardiovascular Risk in Users Versus Non-Users of Xanthine Oxidase Inhibitors and Febuxostat Versus Allopurinol Users - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features (...) a collection: Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Rheumatology (Oxford) Actions 2019 Dec 24 [Online ahead of print] Comparative Cardiovascular Risk in Users Versus Non-Users of Xanthine Oxidase Inhibitors and Febuxostat Versus Allopurinol Users , , , , , , , , , , , , Affiliations Expand Affiliations 1 School of Pharmacy, University College

2020 EvidenceUpdates

5. Heart disease and the risk of allopurinol-associated severe cutaneous adverse reactions: a general population-based cohort study Full Text available with Trip Pro

Heart disease and the risk of allopurinol-associated severe cutaneous adverse reactions: a general population-based cohort study Allopurinol is commonly prescribed for gout, and its clinical use may expand with ongoing trials assessing its potential cardiorenal benefits. Because heart disease has been suggested to be a risk factor for allopurinol-associated severe cutaneous adverse reactions, we sought to confirm this association in a Canadian general population cohort.We used population data (...) from British Columbia, Canada, to identify all incident allopurinol users between 1997 and 2015. We examined the association between heart disease (ischemic heart disease and heart failure) and the risk of hospital admission for severe cutaneous adverse reactions, adjusting for known and purported risk factors. We also evaluated the joint effects of combined clinical and demographic risk factors.Among 130 325 allopurinol initiators, 109 hospital admissions occurred for allopurinol-associated severe

2019 EvidenceUpdates

6. Comparative cardiovascular risk of allopurinol versus febuxostat in patients with gout: a nation-wide cohort study (Abstract)

Comparative cardiovascular risk of allopurinol versus febuxostat in patients with gout: a nation-wide cohort study To compare cardiovascular (CV) risk among gout patients initiating allopurinol vs febuxostat.Using 2002-2015 Korean National Health Insurance Service data for the entire Korean population, we conducted a cohort study on gout patients initiating allopurinol or febuxostat. The primary outcome was a composite CV end point of myocardial infarction, stroke/transient ischaemic attack (...) , or coronary revascularization. Secondary outcomes were individual components of the primary outcome, and all-cause mortality. We used propensity score-matching with a 4:1 ratio for allopurinol and febuxostat initiators to control for confounding. Competing risk analyses were done for non-fatal outcomes accounting for deaths.We included 39 640 allopurinol initiators propensity score-matched on 9910 febuxostat initiators. The mean age was 59.1 years and 78.4% were male. The incidence rate per 100 person

2019 EvidenceUpdates

7. Risk of cutaneous adverse reactions associated with allopurinol or febuxostat in real-world patients: A nationwide study (Abstract)

Risk of cutaneous adverse reactions associated with allopurinol or febuxostat in real-world patients: A nationwide study Allopurinol carries a well-known risk of cutaneous adverse reactions (CARs). Although febuxostat, a xanthine-oxidase inhibitor with different chemical structure, has been considered an alternative to allopurinol, post-marketing case reports of life-threatening febuxostat-related CARs have been reported. We aimed to compare the risk of CARs between allopurinol and febuxostat (...) in real-world settings and to assess the impact of the market entry of febuxostat on allopurinol use and associated CARs.A nationwide study was conducted using Taiwan's National Health Insurance Research Database. In the new-user cohort study, patients who received their first prescriptions of allopurinol or febuxostat were included, and Poisson regression was used to estimate the incidence rate ratios (IRRs) of CARs. In the interrupted time series analysis, time series data on new users and incidence

2019 EvidenceUpdates

8. Gout: Allopurinol

Gout: Allopurinol Allopurinol | Prescribing information | Gout | CKS | NICE Search CKS… Menu Allopurinol Gout: Allopurinol Last revised in February 2018 Allopurinol How should I prescribe allopurinol? Start allopurinol after the acute attack has resolved. In circumstances where attacks are so frequent that this is not possible, the initiation of allopurinol can be considered before inflammation has completely settled. Start allopurinol at a low dose of 50-100 mg once a day (preferably taken (...) with food), increased by 100 mg increments approximately every 4 weeks until the serum uric acid (SUA) level is below 300 micromol/L. For people with renal impairment starting dose and titration guidance may differ. See . The maximum dose of allopurinol for gout prophylaxis is 900mg daily in divided doses (lower in renal impairment). Allopurinol is usually given once a day. However, doses of over 300 mg per day should be taken in divided doses to help minimize any gastrointestinal adverse effects. Use

2019 NICE Clinical Knowledge Summaries

9. Association of Chronic Kidney Disease With Allopurinol Use in Gout Treatment Full Text available with Trip Pro

Association of Chronic Kidney Disease With Allopurinol Use in Gout Treatment Clinicians are often cautious about use of allopurinol in patients with gout when renal function declines.To assess the association of allopurinol use in gout with the risk of developing chronic kidney disease stage 3 or higher.A time-stratified propensity score-matched, population-based, prospective cohort study of individuals with newly diagnosed gout who initiated allopurinol (≥300 mg/d) compared with those who did (...) not initiate allopurinol, using the Health Improvement Network (THIN), a United Kingdom general practitioner electronic health records database, was carried out. The data were analyzed using Cox proportional hazards regression. Among adults aged 18 to 89 years with newly diagnosed gout, we propensity score matched 4760 initiators of allopurinol (≥300 mg/d) to the same number of noninitiators of allopurinol, excluding those with chronic kidney disease stage 3 or higher or urate-lowering therapy use before

2018 EvidenceUpdates

10. Assessment of Cardiovascular Risk in Older Patients with Gout Initiating Febuxostat versus Allopurinol: A Population-Based Cohort Study Full Text available with Trip Pro

Assessment of Cardiovascular Risk in Older Patients with Gout Initiating Febuxostat versus Allopurinol: A Population-Based Cohort Study Hyperuricemia and gout are associated with an increased risk of cardiovascular disease. Xanthine oxidase inhibitors, allopurinol and febuxostat, are the mainstay of urate-lowering treatment for gout and may have different effects on cardiovascular risk in patients with gout.Using US Medicare claims data (2008-2013), we conducted a cohort study for comparative (...) cardiovascular safety of initiating febuxostat versus allopurinol among patients with gout ≥65 years of age. The primary outcome was a composite end point of hospitalization for myocardial infarction or stroke. Secondary outcomes were individual end points of hospitalization for myocardial infarction, stroke, coronary revascularization, new and recurrent heart failure, and all-cause mortality. We used propensity score matching with a ratio of 1:3 to control for confounding. We estimated incidence rates

2018 EvidenceUpdates

11. Allopurinol / lesinurad (Duzallo) - Gout

Allopurinol / lesinurad (Duzallo) - Gout 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 28 June 2018 EMA/474026/2018 Committee for Medicinal Products for Human Use (CHMP) Assessment report Duzallo International non-proprietary (...) name: allopurinol / lesinurad Procedure No. EMEA/H/C/004412/0000 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. Assessment report EMA/474026/2018 Page 2/100 Table of contents 1. Background information on the procedure 6 1.1. Submission of the dossier 6 1.2. Steps taken for the assessment of the product 6 2. Scientific discussion 8 2.1. Problem statement 8 2.1.1. Disease or condition 8 2.1.2. Epidemiology 8 2.1.3. Aetiology

2018 European Medicines Agency - EPARs

12. Maternal Allopurinol Prevents Cardiac Dysfunction in Adult Male Offspring Programmed by Chronic Hypoxia During Pregnancy Full Text available with Trip Pro

Maternal Allopurinol Prevents Cardiac Dysfunction in Adult Male Offspring Programmed by Chronic Hypoxia During Pregnancy Integrating functional and molecular levels, we investigated the effects of maternal treatment with a xanthine oxidase inhibitor on the programming of cardiac dysfunction in adult offspring using an established rat model of hypoxic pregnancy. Female Wistar rats were divided into normoxic or hypoxic (13% O2) pregnancy±maternal allopurinol treatment (30 mg kg-1 d-1). At 4 (...) %) and the cardiac expression of SERCA2a (+71.4%) were also elevated ( P<0.05), further linking molecular markers of cardiac stress and injury to dysfunction. Maternal allopurinol restored all functional and molecular indices of cardiac pathology. The data support a link between xanthine oxidase-derived oxidative stress in hypoxic pregnancy and cardiac dysfunction in the adult offspring, providing a target for early intervention in the developmental programming of heart disease.

2018 Hypertension (Dallas, Tex. : 1979)

13. Allopurinol

Allopurinol Top results for allopurinol - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for allopurinol The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you

2018 Trip Latest and Greatest

14. Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. Full Text available with Trip Pro

Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease.We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease (...) ; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function. The trial had a prespecified noninferiority margin of 1.3 for the hazard ratio for the primary end point (a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization).In total, 6190 patients underwent randomization, received febuxostat or allopurinol, and were followed for a median of 32 months (maximum, 85

2018 NEJM Controlled trial quality: predicted high

15. Effect of administration of allopurinol on postoperative outcomes in patients undergoing intracardiac repair of tetralogy of Fallot Full Text available with Trip Pro

Effect of administration of allopurinol on postoperative outcomes in patients undergoing intracardiac repair of tetralogy of Fallot To determine effects of allopurinol administration on outcomes following intracardiac repair of tetralogy of Fallot (TOF).Fifty patients undergoing TOF repair were randomized to 2 groups of 25 each: the allopurinol group (n = 25) and the placebo group (n = 25). Postoperatively, inotropic score, rhythm, duration of mechanical ventilation, cardiac output, intensive (...) care unit (ICU) stay, and hospital stay were assessed. Plasma troponin-I, superoxide dismutase (SOD), interleukin (IL) 1-ß, IL-6, and malondialdehyde were measured serially.Inotropic score was lower in the allopurinol compared with placebo group (11.04 ± 5.70 vs 17.50 ± 7.83; P = .02). Duration of ICU and hospital stay was lower in the allopurinol group. Plasma levels of SOD preoperative were (2.87 ± 1.21 U/mL vs 4.5 ± 2.08 U/mL; P = .012), immediately following release of crossclamp (2.32 ± 0.98 U

2018 EvidenceUpdates

16. Treatment with Allopurinol is Associated with Lower Risk of Acute Kidney Injury in Patients with Gout: A Retrospective Analysis of a Nested Cohort Full Text available with Trip Pro

Treatment with Allopurinol is Associated with Lower Risk of Acute Kidney Injury in Patients with Gout: A Retrospective Analysis of a Nested Cohort Gout is characterized by recurrent episodes of acute inflammation of joint structures, called gout flares, and flares are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs). The objective of the study was to evaluate risk factors associated with acute kidney injury (AKI) attributed to NSAIDs in a cohort of patients who were exposed (...) associated with higher risk of renal events. Other variables previously described in the literature, such as previous chronic renal disease, use of diuretics, and presence of previous vascular events, were also independently associated with increased risk of AKI. Interestingly, patients who had been previously prescribed allopurinol showed a lower risk of acute renal events.In addition to classic risk factors, the number of flares and extensive joint distribution were associated with higher risk

2017 Rheumatology and therapy

17. Starting allopurinol in acute gout

Starting allopurinol in acute gout Starting allopurinol in acute gout – Morsels of Evidence \t\t\t\r\n\t\t\t \t\t\t\r\n\t\t\t Like this: Like Loading... ","author":{"@type":"Person","name":"Michael Tam"},"image":["https:\/\/evidencebasedmedicine.com.au\/wp-content\/uploads\/2015\/10\/MO20151030.png"]} Toggle search form Toggle navigation Evidence-based medicine for general practitioners Oct 30 2015 Starting allopurinol in acute gout By in , Journal reference: Hill EM, Sky K, Sit M, Collamer (...) A, Higgs J. Does starting allopurinol prolong acute treated gout? A randomized clinical trial. J Clin Rheumatol 2015;21(3):120-5. Link: Published: April 2015 Evidence cookie says… It is unclear what effect starting allopurinol in acute gout has on symptoms, due to the lack of good evidence. it may be preferable to avoid starting allopurinol in an acute attack this should not be a dogmatic stance Clinical scenario Zhongyu, a 50-year-old allied health practitioner presented with a recurrence of podagra

2015 Morsels of Evidence

18. Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study. Full Text available with Trip Pro

Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study. To evaluate the use of prospective screening for the HLA-B*58:01 allele to identify Taiwanese individuals at risk of severe cutaneous adverse reactions (SCARs) induced by allopurinol treatment.National prospective cohort study.15 medical centres in different regions of Taiwan, from July 2009 to August 2014.2926 people who had an indication for allopurinol (...) treatment but had not taken allopurinol previously. Participants were excluded if they had undergone a bone marrow transplant, were not of Han Chinese descent, and had a history of allopurinol induced hypersensitivity. DNA purified from 2910 participants' peripheral blood was used to assess the presence of HLA-B*58:01.Incidence of allopurinol induced SCARs with and without screening.Participants who tested positive for HLA-B*58:01 (19.6%, n=571) were advised to avoid allopurinol, and were referred

2015 BMJ

19. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Human Leukocyte Antigen-B (HLA-B) Genotype and Allopurinol Dosing

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Human Leukocyte Antigen-B (HLA-B) Genotype and Allopurinol Dosing Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Human Leukocyte Antigen B (HLA-B) Genotype and Allopurinol Dosing: 2015 Update YSaito 1 ,LKStamp 2 ,KECaudle 3 ,MSHershfield 4 ,EMMcDonagh 5 ,JTCallaghan 6,7,8 ,WTassaneeyakul 9 , TMushiroda 10 ,NKamatani 11 ,BRGoldspiel 12 ,EJPhillips 13,14 ,TEKlein 5 andMTMLee 15,16,17 The Clinical (...) and information that would modify prescribing recommendations pertaining to gene speci?c alleles and nomenclature are updated periodically on the PharmGKB website. Furthermore, published CPIC guidelines are currently systematically reviewed for updates periodically. The CPIC Guideline for HLA-B Genotype and Allopurinol Dosing was originally published in February 2013. 2 To update this guideline, we conducted a focused review of the literature published between 1966 to October 2014 on HLA genotype

2015 Clinical Pharmacogenetics Implementation Consortium

20. Allopurinol for the treatment of chronic kidney disease: a systematic review

Allopurinol for the treatment of chronic kidney disease: a systematic review Allopurinolforthetreatmentofchronic kidneydisease:asystematicreview Nigel Fleeman, 1* Gerlinde Pilkington, 1 Yenal Dundar, 1 Kerry Dwan, 1 Angela Boland, 1 Rumona Dickson, 1 Hameed Anijeet, 2 Tom Kennedy 2 and Jason Pyatt 2 1 Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK 2 Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK *Corresponding author Declared (...) . Allopurinol (Zyloric ® , Aspen) is a drug commonly used to treat hyperuricaemia in patients with gout. Evidence is emerging that it may also have a role to play in slowing down the progression of CKD and reducing the risk of CVD. Objectives The aim of this systematic review was to address the following research question: does allopurinol reduce mortality, the progression of chronic kidney disease or cardiovascular risk in people with CKD? Given the importance of adverse events (AEs) (common and rare

2014 NIHR HTA programme