Initiation of Allopurinol at First Medical Contact for Acute Attacks of Gout: A Randomized Clinical Trial

Taylor, Thomas H.; Mecchella, John N.; Larson, Robin J.; Kerin, Kevin D.; MacKenzie, Todd A.

doi:10.1016/j.amjmed.2012.05.025

Cited by 112 publications

(70 citation statements)

References 33 publications

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“…Taylor et al reported a prospective randomized study addressing this question on a small number of patients. Allopurinol initiation during an acute gout attack caused no significant difference in daily pain, recurrent flares, or inflammatory markers [9]. In our study, patients initiating ULT during an acute gout attack exhibited numerically higher attack rates than those in the other group, during the first 12 weeks.…”

Section: Discussioncontrasting

confidence: 53%

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Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Feng

Gao

2015

Joint Bone Spine

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Section: Discussioncontrasting

confidence: 53%

“…This is an approach that runs counter to previous recommendations. Taylor flares [9]. In other words, the question of when to begin ULT to prevent and reverse urate deposition remains debatable.…”

Section: Introductionmentioning

confidence: 99%

Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Feng

Gao

2015

Joint Bone Spine

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“…In the very first randomized, double-blind, placebo-controlled research [20] of patients started on an adequate dose (300 mg) of allopurinol throughout the acute gout attack, while all at once treated with indomethacin and colchicine, created remarkably similar declines in VAS and self identified gout flares, with narrow CIs. Although an ample dose of allopurinol is whatever dose is needed to achieve a serum urate listed below the objective of 6.0 mg/ dL, a starting dose of 300 mg of allopurinol stays clear of the complicated tipped increments advised by guidelines [15] .…”

Section:  Allopurinol In Treatment Of Goutmentioning

confidence: 99%

Overview of Allopurinol Decisions in Primary Care: A Narrative Review

Alshamrani¹

2018

The Egyptian Journal of Hospital Medicine

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Background: Allopurinol is a type of drug called a xanthine oxidase inhibitor. It functions by lowering the production of uric acid in the body. It can be found in the kind of an oral tablet. Generalist physicians, specifically general internists and primary care physicians, are usually the first to see individuals with gout and for that reason play an essential role in the diagnosis and management of these patients. Gout is mostly managed in primary care and lasting treatment aims to reduce serum uric acid degrees with using allopurinol. Urate lowering therapy is indicated in patients who have had an acute gout attack and whose uric acid level remains high, increasing the risk of a subsequent attack. The effect of allopurinol on uric acid level is dose dependent and variable. Aim of the Study: In the present review, we aimed at discussing the indications of Allopurinol in primary care along with its benefits and side effects which should be considered by patients and physicians before prescribing it. Methods: Narrative review was conducted using electronic database such as; PubMed/Medline, Embase, Google scholar, for relevant articles related to our concerned topic which is about the usage of allopurinol in primary care and methods that family doctors use to make a decision about the usage, published up to 2018. Conclusion: The benefit-risk balance of allopurinol should be carefully assessed with respect to the patients' condition and medical profile before prescription in the PCU.

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“…It is generally recommended that allopurinol should not be started or stopped during a flare as it has been suggested that these situations may worsen the attack and make the recovery longer. Recent data, albeit of two small studies, suggest that these fears might be misplaced [Hill et al 2015;Taylor et al 2012]; but in any case there is no reason to stop the SUA lowering treatment during a flare.…”

Section: Xanthine Oxidase Inhibitorsmentioning

confidence: 99%

Gout: optimizing treatment to achieve a disease cure

Bernal

Quilis

Andrés

et al. 2016

Therapeutic Advances in Chronic Disease

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Gout is one of the most common inflammatory arthritides. The disease is due to the deposition of monosodium urate crystals. These deposits are reversible with proper treatment, suggesting that gout is a curable disease. The main aim in gout is to lower serum uric acid levels to a pre-established target; there are different urate-lowering drugs (xanthine oxidase inhibitors, uricosurics and uricases) through which this can be achieved. Proper treatment of gout also involves correct management of acute flares and their prevention. To ensure treatment adherence it is necessary to explain to the patient what the objectives are.

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Initiation of Allopurinol at First Medical Contact for Acute Attacks of Gout: A Randomized Clinical Trial

Cited by 112 publications

References 33 publications

Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Overview of Allopurinol Decisions in Primary Care: A Narrative Review

Gout: optimizing treatment to achieve a disease cure

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