Zoxazolamine as a uricosuric agent. II. Clinical evaluation in the treatment of gout

Abstract

Zoxazolamine was a well-tolerated and effective uricosuric agent in 20 gouty patients treated for 3 to 31 months. Cardiovascular disease adversely affected the uricosuric response. Increases in creatinine clearance during treatment indicate that gout nephropathy may be reversible. Evidence suggesting that inadequate fluid intake may hasten the development of renaI complications in gout is presented.Zoxazolamina se provava un ben-tolerate e efficace agente uricosuric in 20 patientes guttose tractate durante periodos de inter 3 e 31 menses. Morbo cardiovascular exerceva un effect0 adverse in le responsa uricosuric. Augmentationes del clearance de creatinina durante le tractamento indica que le nephropnthia de gutta es possibilemente revertibile. Es presentate datos que suggere que un inadequate ingestion de liquid0 accelera possibilemente le disveloppamento de complicationes renal in le presentia de gutta.OXAZOLAMINE* had been in clinical use as a skeletal muscle relaxant Z for over a year at the time it was found to have uricosuric activi9.l The apparently low toxicity of this d r~g~-~ and its remarkable potency as a uricosuric agent suggested that it might be a useful addition to the small number of drugs suitable for the treatment of chronic gout. This report presents observations on the effects of long term administration of zoxazolamine to gouty patients during the period January 1958 to January 1961.t In the course of treatment, one patient developed hepatitis. In this instance, the hepatitis could not be attributed to zoxazolamine. However, other cases of hepatitis in patients taking zoxazolamine have been reported with a presumptive diagnosis of drug t o x i~i t y .~,~ Although "zoxazolamine hepatitis" is apparently indistinguishable from viral hepatitis, the manufacturers have recently decided to withdraw zoxazolamine from the market. SUBJECTS AND METHODSThe 20 patients included in this study (table 1 ) had each experienced a minimum of two episodes of acute gouty arthritis; half of the group had chronic tophaceous gout. The clinical severity of gout ranged from relatively mild to nearly totally disabling. A family history of gout was present only in cases 3, 4, 12 and 18. A majority of patients, hospitalized for diseases other than gout, had associated conditions, the most common of which are listed in *Zoxazolamine ( 2-amino-5-chloro-benzoxazole), in the form of Flexin; generously supplied by Drs.