Higher doses of allopurinol may benefit gout patients

New research suggests that people with gout may benefit from taking more than the recommended dose of allopurinol, a drug that helps to lower the level of urate in the blood.

Excess urate usually passes out of the body through the kidneys, but the level of blood urate is raised in people with gout and this leads to the formation of crystals in and around the joints.

Allopurinol is designed to lower the level of urate in the blood, but many patients do not achieve a desirable level of the chemical while taking the recommended dose of the drug.

Now, scientists at the University of Otago in New Zealand have shown that a dose higher than that recommended by health experts may be beneficial in these patients and may be administered without causing additional side-effects.

In a presentation at the annual meeting of the American College of Rheumatology, they revealed the results of a trial involving 90 people with gout, 52 of whom had serum uric acid levels above 6mg/dL.

The researchers asked 45 of the participants to increase their dose of allopurinol to between 50 and 400mg above the recommended dose.

Among those who took a higher dose for 12 months, 86 per cent benefited from a fall in blood urate levels to 6mg/dL or less.

Rheumatologist Dr Lisa Stamp, from the University of Otago, commented: "While allopurinol is the mainstay of treatment, physicians have concerns about increasing the dose above recommended guidelines, particularly in patients with impaired kidney function.

"This study lends support to the practice of many rheumatologists in which the goal in gout treatment is to achieve a target urate less than 6 mg/dL rather than persisting with a perceived safe but inadequate allopurinol dose."

A spokesman for the Arthritis Research Campaign said the study's findings would be welcome to many gout sufferers, many of whom do not currently gain an adequate response from allopurinol.

© Adfero Ltd

Recent related stories:

'Smart coating' may improve hip and knee implants
05 February 2010
UK scientists discover new treatment for rare pain syndrome
02 February 2010
New technique may reduce need for hip replacement after injury
01 February 2010
EU approves abatacept for polyarticular juvenile idiopathic arthritis
26 January 2010
Cartilage repair technique may delay osteoarthritis progression
25 January 2010
'Electro-acupuncture' may be effective for knee arthritis
22 January 2010
NICE approves new rheumatoid arthritis drug certolizumab pegol
21 January 2010

Want to know more?