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Study: Allopurinol does not prolong acute gout attacks
Results from a study of patients with acute gout attacks showed treatment with low-dose allopurinol did not prolong the attacks, according to researchers.
Patients were enrolled at the San Antonio Military Medical Center after referral from another physician. The study included 31 patients (mean age: 57 years). Before arrival at the medical center, more than 80% of all patients were treated with intra-articular, intramuscular or oral corticosteroids.
Once enrolled, patients were randomly assigned to placebo or to treatment with 0.6 mg prophylactic oral colchicine daily for 2 days and 0.6 mg twice daily through day 28. One patient in the placebo group received meloxicam instead of colchicine, and one placebo patient received no prophylaxis due to intolerance.
The researchers evaluated patients at five visits staggered over 28 days, with follow-up on days 1, 3 to 4, 10 to 15, 20 to 25 and 28, to determine resolution of the initial gout attack, identify any evidence of a new acute attack in the affected joint or joints, and to identify any potential medication toxicity.
Mean serum uric acid levels were 8.16 mg/dL in the patients assigned to allopurinol and 7.95 mg/dL in the group assigned to placebo at baseline. Rates of tophi and disease duration were similar in each group, according to the researchers.
Among the 31 patients who completed the study (17 in the placebo group, 14 in the allopurinol group), a statistically insignificant increase of 2 days to resolve symptoms was seen in the group treated with allopurinol. Patients in both groups reported low pain scores after 3 or 4 days of treatment, although two patients in the allopurinol group and one in the placebo group reported pain in a new joint.
At the end of the study period, gout attacks were resolved in all patients, but mean serum uric acid level in patients taking allopurinol was 6.42 mg/dL compared with 8.25 mg/dL in the placebo group. - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.