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Latest & greatest articles for allopurinol
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Allopurinol for the treatment of chronic kidney disease: a systematic review Allopurinol for the treatment of chronic kidney disease: a systematic review Allopurinol for the treatment of chronic kidney disease: a systematic review Fleeman N, Pilkington G, Dundar Y, Dwan K, Boland A, Dickson R, Anijeet H, Kennedy T, Pyatt J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Fleeman N, Pilkington G, Dundar Y, Dwan K, Boland A, Dickson R, Anijeet H, Kennedy T, Pyatt J. Allopurinol for the treatment of chronic kidney disease: a systematic review. Health Technology Assessment 2014; 18(40): 106 Authors' 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
Allopurinol USE OF ALLOPURINOL IN PREGNANCY 0344 892 0909 USE OF ALLOPURINOL IN PREGNANCY (Date of issue: September 2014 , Version: 1 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . A corresponding patient information leaflet on is available at . Summary Allopurinol is a hypoxanthine analogue that inhibits xanthine (...) oxidase, thus decreasing the production of uric acid. Allopurinol is used primarily in the management or prophylaxis of gout, uric acid and calcium oxalate renal calculi, and hyperuricaemia associated with cancer chemotherapy. Allopurinol is also occasionally used in the treatment of inflammatory bowel disease and as a thiopurine adjunct in renal transplant recipients. The conditions for which allopurinol is used are generally rare in women of childbearing age, and human data on allopurinol use during
Randomized Controlled Trial of Febuxostat Versus Allopurinol or Placebo in Individuals with Higher Urinary Uric Acid Excretion and Calcium Stones Higher urinary uric acid excretion is a suspected risk factor for calcium oxalate stone formation. Febuxostat, a xanthine oxidoreductase inhibitor, is effective in lowering serum urate concentration and urinary uric acid excretion in healthy volunteers and people with gout. This work studied whether febuxostat, compared with allopurinol and placebo (...) , would reduce 24-hour urinary uric acid excretion and prevent stone growth or new stone formation.In this 6-month, double-blind, multicenter, randomized controlled trial, hyperuricosuric participants with a recent history of calcium stones and one or more radio-opaque calcium stone ≥ 3 mm (as seen by multidetector computed tomography) received daily febuxostat at 80 mg, allopurinol at 300 mg, or placebo. The primary end point was percent change from baseline to month 6 in 24-hour urinary uric acid
Initiation of allopurinol at first medical contact for acute attacks of gout: a randomized clinical trial Streamlining the initiation of allopurinol could result in a cost benefit for a common medical problem and obviate the perception that no treatment is required once acute attacks have resolved. Our objective was to test the hypothesis that there is no difference in patient daily pain or subsequent attacks with early versus delayed initiation of allopurinol for an acute gout attack.A total (...) of 57 men with crystal-proven gout were randomized to allopurinol 300 mg daily or matching placebo for 10 days. All subjects received indomethacin 50 mg 3 times per day for 10 days, a prophylactic dose of colchicine 0.6 mg 2 times per day for 90 days, and open-label allopurinol starting at day 11. Primary outcome measures were pain on visual analogue scale (VAS) for the primary joint on days 1 to 10 and self-reported flares in any joint through day 30.On the basis of 51 evaluable subjects
Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Experimental evidence suggests that xanthine oxidase inhibitors can reduce myocardial oxygen consumption for a particular stroke volume. If such an effect also occurs in man, this class of inhibitors could become a new treatment for ischaemia in patients with angina pectoris. We ascertained whether high-dose allopurinol prolongs exercise capability in patients (...) with chronic stable angina.65 patients (aged 18-85 years) with angiographically documented coronary artery disease, a positive exercise tolerance test, and stable chronic angina pectoris (for at least 2 months) were recruited into a double-blind, randomised, placebo-controlled, crossover study in a hospital and two infirmaries in the UK. We used computer-generated randomisation to assign patients to allopurinol (600 mg per day) or placebo for 6 weeks before crossover. Our primary endpoint was the time
2010LancetControlled trial quality: predicted high
A randomised controlled trial on the efficacy and tolerability with dose escalation of allopurinol 300-600 mg/day versus benzbromarone 100-200 mg/day in patients with gout To compare the efficacy and tolerability of allopurinol 300-600 mg/day versus benzbromarone 100-200 mg/day used to attain a target serum urate concentration (sUr) < or =0.30 mmol/l (5 mg/dl).A randomised, controlled, open-label, multicentre trial in gout patients with renal function defined as a calculated creatinine (...) clearance > or =50 ml/min. Patients were treated with 300 mg allopurinol or 100 mg benzbromarone once a day (stage 1). If sUr < or =0.30 mmol/l was not attained after 2 months, the dose was doubled to allopurinol 300 mg twice a day or benzbromarone 200 mg once a day (stage 2). The primary end point was treatment success in either of the two stages, defined as clinical tolerability and attainment of biochemical target sUr.Sixty-five patients were enrolled in stage 1; 36 received allopurinol and 29
Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. Hyperuricemia is a predictor for the development of hypertension and is commonly present in new-onset essential hypertension. Experimentally increasing uric acid levels using a uricase inhibitor causes systemic hypertension in animal models.To determine whether lowering uric acid lowers blood pressure (BP) in hyperuricemic adolescents with newly diagnosed (...) mg twice daily for 4 weeks, and placebo, twice daily for 4 weeks, with a 2-week washout period between treatments. The order of the treatments was randomized.Change in casual and ambulatory blood pressure.For casual BP, the mean change in systolic BP for allopurinol was -6.9 mm Hg (95% confidence interval [CI], -4.5 to -9.3 mm Hg) vs -2.0 mm Hg (95% CI, 0.3 to -4.3 mm Hg; P = .009) for placebo, and the mean change in diastolic BP for allopurinol was -5.1 mm Hg (95% CI, -2.5 to -7.8 mm Hg) vs -2.4
Meta-analysis of prophylactic allopurinol use in post-endoscopic retrograde cholangiopancreatography pancreatitis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Meta-analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis Meta-analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis Meta-analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis Bai Y, Gao J, Zhang W, Zou D, Li Z CRD summary The review concluded that prophylactic allopurinol may not be useful for postendoscopic retrograde (...) cholangiopancreatography pancreatitis. This was a reasonably well conducted review. The authors' conclusions reflected the results of the review and appear likely to be reliable, but the lack of study details and statistical heterogeneity should be borne in mind. Authors' objectives To assess the effect of prophylactic allopurinol compared with placebo on pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). Searching MEDLINE, EMBASE, The Cochrane Library and Science Citation Index were
Febuxostat compared with allopurinol in patients with hyperuricemia and gout. Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase, is a potential alternative to allopurinol for patients with hyperuricemia and gout.We randomly assigned 762 patients with gout and with serum urate concentrations of at least 8.0 mg per deciliter (480 micromol per liter) to receive either febuxostat (80 mg or 120 mg) or allopurinol (300 mg) once daily for 52 weeks; 760 received the study drug (...) of those receiving allopurinol (P<0.001 for the comparison of each febuxostat group with the allopurinol group). Although the incidence of gout flares diminished with continued treatment, the overall incidence during weeks 9 through 52 was similar in all groups: 64 percent of patients receiving 80 mg of febuxostat, 70 percent of those receiving 120 mg of febuxostat, and 64 percent of those receiving allopurinol (P=0.99 for 80 mg of febuxostat vs. allopurinol; P=0.23 for 120 mg of febuxostat vs
Allopurinol Neurocardiac Protection Trial in Infants Undergoing Heart Surgery Using Deep Hypothermic Circulatory Arrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Allopurinol for chronic prostatitis. To determine the effects of allopurinol in the treatment of chronic prostatitisTrials were searched in computerized general and specialized databases (MEDLINE, Cochrane Library, Cochrane Prostate Group database), bibliographies of obtained articles, and direct contact with authors.All randomized trials of allopurinol versus placebo used to treat patients with chronic prostatitis. Acute prostatitis, bacterial prostatitis, and asymptomatic prostatitis were (...) excluded. The main outcome measure was the change in patient-reported discomfort.The reviewers extracted the data independently for the outcomes of change in patient-reported discomfort, investigator graded prostate pain, leukocyte counts, and biochemical indices.Only one trial with 54 men lasting 240 days (with 330 days of follow-up) met study inclusion criteria. There was a statistically significant change favoring allopurinol in patient-reported discomfort between the study and control groups
Allopurinol in the treatment of American cutaneous leishmaniasis. Pentavalent antimony, the generally accepted treatment for leishmaniasis, is given parenterally, and it is expensive and not readily available in developing countries. An inexpensive, orally administered compound would be a substantial advance in treatment. Previous studies in vitro have shown synergism between allopurinol and pentavalent antimony in tissue-culture systems. We designed this clinical study to determine whether (...) synergism could be demonstrated in patients.We performed a randomized, controlled study of the efficacy of allopurinol plus meglumine antimoniate (Glucantime), as compared with meglumine antimoniate alone, in patients with cutaneous leishmaniasis, who were recruited from a village in southeastern Colombia. In addition, those who declined injections were treated with allopurinol alone, and those who declined any treatment were considered controls. All the patients were followed for one year after
Randomized trial of allopurinol in the prevention of calcium oxalate calculi. In a double-blind study, we examined the efficacy of allopurinol in the prevention of recurrent calcium oxalate calculi of the kidney. Sixty patients with hyperuricosuria and normocalciuria who had a history of calculi were randomly assigned to receive either allopurinol (100 mg three times daily) or a placebo. After the study, the placebo group had 63.4 percent fewer calculi (P less than 0.001), whereas (...) the allopurinol group had 81.2 percent fewer calculi (P less than 0.001). During the study period, the mean rate of calculous events was 0.26 per patient per year in the placebo group and 0.12 in the allopurinol group. When the treatment groups were compared by actuarial analysis, the allopurinol group was found to have a significantly longer time before recurrence of calculi (P less than 0.02). We conclude that allopurinol is effective in the prevention of calcium oxalate stones in patients
The effect of dietary protein on the clearance of allopurinol and oxypurinol. A decrease in dietary protein is known to depress renal plasma flow and creatinine clearance. Using a randomized crossover design, we investigated the pharmacokinetics of allopurinol and its principal metabolite, oxypurinol, after oral administration of 600 mg of allopurinol in six normal subjects receiving a high-protein (268 g per day) or low-protein (19 g per day) diet. For allopurinol, the area under the curve (...) of plasma concentration versus time increased by a factor of 1.45 (P less than 0.02), the renal clearance decreased by 28 per cent (P less than 0.02), and the ratio of the clearance of allopurinol to that of creatinine (fractional excretion) was unchanged between the low-protein and high-protein diets. For oxypurinol, the area under the curve increased nearly three-fold (P less than 0.02), the renal clearance decreased by 64 per cent (P less than 0.02), the fractional excretion decreased by 49 per cent