Stamp LK et al. – The study determined long–term safety and efficacy of dose escalation (DE) of allopurinol to achieve target serum urate (SU) in gout. The study concluded that a majority of the people with gout achieved and maintained target SU and tolerated higher than creatine clearance–based allopurinol dose. Allopurinol dose escalation (DE) was also shown to be appropriate in clinical practice, even in patients with kidney impairment.

Methods

• Patients with chronic kidney disease who completed a 12–month randomized control trial continued to a 12–month extension study.
• Allopurinol DE was administered to randomized patients on current dose, at month 12 if SU was ≥6 mg/dL (control/DE) and allopurinol dose was maintained for patients who achieved target SU (DE/DE).

Results

• Control/DE and DE/DE groups revealed a mean (standard error [SE]) change in SU of –1.1 (0.2) mg/dL and 0.1 (0.2) mg/dL, respectively from month 12 to 24.
• The percentage of individuals having a gout flare in the month prior to months 12 and 24 significantly reduced compared with baseline in both groups and in mean tophus size over 24 months with no difference between the randomized groups.
Similar numbers of adverse events (AEs) and serious AEs were reported between groups.