No abstract available.
Allopurinol* ; Alprostadil* ; Skin*

Allopurinol is the well-known first-line treatment option for symptomatic hyperuricaemia and gout. It is cost-effective particularly for the management of chronic gout. The common early side effects of allopurinol are skin rashes, diarrhoea and nausea. Meanwhile, a dangerous concerning complication is Stevens–Johnson syndrome, which can cause severe morbidity and mortality. Delayed hypersensitivity to allopurinol is rare but should be one of the differential diagnoses if a patient with underlying gout on chronic allopurinol treatment presents with skin rashes. The present case highlights the importance of a high index of suspicion in at-risk patients with underlying gout along with skin rashes on long-term allopurinol treatment to avoid unnecessary patient management.
Hypersensitivity, Delayed ; Allopurinol ; Exanthema

No abstract available.
Allopurinol* ; Febuxostat* ; Xanthine Oxidase* ; Xanthine*

Background: One of the causes of inflammatory arthritis is excessive production of uric acid or hyperuricemia. It is a painful disease that is treated with a commercial xanthine oxidase inhibitor to decrease uric acid synthesis. However, the treatment is associated with adverse side effects and thus, there is interest in medicinal plants that could have similar therapeutic effects with minimal side effects. There are many reported indigenous plants and trees in the Philippines that are reported to have therapeutic and bioactive compounds. One such plant is Canarium ovatum or locally called pili. This study aimed to determine the antihyperuricemic activity of the ethanolic extract of the leaves of C. ovatum. Objective: Determine the antihyperuricemic activity of the crude ethanolic extract of C. ovatum leaves and its partially purified fractions through inhibition of xanthine oxidase and its effect on the blood uric acid level of oxonate-induced hyperuricemic mice. Methodology: The crude ethanol extract from C. ovatum leaves and its partially purified fractions obtained through column chromatography were tested for their in vitro xanthine oxidase (XO) inhibitory activity by measuring spectrophotometrically the uric acid formation from xanthine as the substrate. The crude ethanol extract and the fraction with the most XO inhibitory activity were then tested for their in vivo XO inhibitory activity in oxonate-induced hyperuricemic mice by measuring their blood uric acid levels using uric acid test strips. Results: The crude ethanolic extract of C. ovatum leaves at 100ppm showed 83.62±2.05% in vitro inhibition of XO while the most active fraction showed 80.30±4.00% inhibition. Both were comparable (p>0.05) to the positive control, allopurinol, which showed 91.47±5.64% inhibition. In vivo, the crude extract and the fraction that showed the highest XO inhibitory activity at 200 mg/kg significantly (p<0.01 and p<0.05) respectively reduced the serum uric acid levels of the hyperuricemic mice one hour after induction as compared to the negative control. Moreover, their antihyperuricemic activity were not statistically significant as compared to that of allopurinol (p<0.0001). Conclusion The crude ethanolic extract of C. ovatum leaves and its most active fraction showed statistically significant in vitro xanthine oxidase inhibition and in vivo antihyperuricemic activity. The activities shown by both crude and active fraction were not statistically different from that determined for allopurinol. Therefore, further studies can be conducted to isolate the most active compound and study its pharmacokinetic properties.
Xanthine Oxidase ; Uric Acid ; Allopurinol

OBJECTIVE: The aim of this study was to assess the relative urate-lowering efficacy and safety of febuxostat and allopurinol in hyperuricemic patients with or without gout. METHODS: Randomized controlled trials (RCTs) examining the efficacy and safety of febuxostat compared to allopurinol or placebo in hyperuricemic patients with/without gout were included in this Bayesian network meta-analysis. RESULTS: Eight RCTs including 4,099 patients met the inclusion criteria. The number of subjects achieving a serum urate (sUA) level <6.0 mg/dL was significantly higher in the febuxostat 120 mg and 80 mg groups than in the allopurinol (100 to 300 mg) group (odds ratio [OR] 7.17, 95% credible interval [CrI] 3.86 to 14.09; OR 3.49, 95% CrI 1.97 to 5.91, respectively). However, achievement of the target sUA level was comparable between febuxostat 40 mg and allopurinol. Ranking probability based on surface under the cumulative ranking curve (SUCRA) indicated that febuxostat 120 mg had the highest probability of being the best treatment for achieving the target sUA (SUCRA=0.9973), followed by febuxostat 80 mg (SUCRA=0.752), febuxostat 40 mg (SUCRA=0.4289), allopurinol (SUCRA=0.3217), and placebo (SUCRA=0). In contrast, no significant difference in safety based on the number of withdrawals due to adverse events was observed among the 5 interventions. CONCLUSION: Febuxostat 80 mg and 120 mg were more efficacious than allopurinol (100 to 300 mg), and febuxostat 40 mg and allopurinol were comparable in urate-lowering efficacy. The safety of febuxostat at all doses was comparable with that of allopurinol.
Allopurinol* ; Gout ; Humans ; Hyperuricemia* ; Uric Acid ; Febuxostat

The objectives of this study sere to investigate how the local irradiation affect the survival of random pattern skin flap, and whether or not hyperbaric oxygen and allopurional can improve the survival of the irradiated rat skin flap. There have been many reports about the effects of hyperbaric oxygen and allpurinol on skin flaps. However, very few reports have been presented on the effects of hyperbaric oxygen and allpurinol in treating irradiated skin flaps. The author examined the local irradiation effect on rat skin flap survival after irradiation of 20 Gy, 3 days postoperatively, on cranially based random pattern dorsal skin flap, which was 3 x 9cm in size. The flap survival length was measured in experimental groups treated with hyperbaric oxygen (2.5 atm absolute, 100% oxygen, once a day for 7days) after irradiation and with hyperbaric oxygen combined with allopurinol (100mg/kg, once a day for 7 days), in comparison with a radiation-only group. On reviewing the flap survival length 10 days postoperati-vely, the average flap survival length in the radiation-only group was 2.2+/-0.5cm, while in the non-radiation group it was 5.5+/-0.3cm. The reduction ratio of flap survival by irradiation was 60%. There was a significant increase in the mean flap survival length in the groups treated with hyperbaric oxygen (4.0+/-1.6cm) and hyperbaric oxygen combined with allopurinol (5.5+/-1.8cm). The increased ratio of flap survival in each group was 85% and 150% when compared to the radiation-only group. The author found that rat skin flap survival decreased, even at an early stage, as a result of high dose local irradiation and that decreased flap survival by irradiation could be restored by hyperbaric oxygen and allopurinol. The group treated with hyperbaric oxygen combined with allopurinol showed increased flap survival over the group treated with hyperbaric oxygen only. The results showed a method which could possibly increase flap survival in cancer patients who require early radiation after flap surgery.
Allopurinol* ; Animals ; Humans ; Oxygen* ; Rats* ; Skin*

No abstract available.
Allopurinol* ; Animals ; Liver* ; Rats* ; Reperfusion Injury* ; Verapamil*

OBJECTIVE: To compare the urate-lowering efficacy and the safety of febuxostat, allopurinol and placebo in Korean patients with gout for 4 weeks. METHODS: Subjects (n=182) with gout were randomized to febuxostat (40, 80, 120 mg), allopurinol 300 mg, or placebo group. The primary end point was the proportion of subjects whose serum urate concentration fell to less than 6.0 mg/dL after the 4-week treatment. RESULTS: The primary end point was reached at 25.7%, 80.0% and 83.3% of patients receiving 40, 80 and 120 mg of febuxostat, respectively, 58.3% of those receiving 300 mg of allopurinol and none of the placebo (p<0.001: each febuxostat dose or allopurinol group versus placebo group, p=0.0484 and p=0.0196: febuxostat 80 and 120 mg compared with allopurinol, respectively). The number and proportion of subjects who developed adverse events (AEs) were 13 subjects (37%), 14 (39%) and 18 (50%) in the febuxostat of 40, 80 and 120 mg group, respectively, 21 (57%) in the allopurinol 300 mg group and 17 (46%) in the placebo group. No statistically significant differences in the incidence rates of adverse events were observed between the groups. There was no significant difference in gout flare-up incidence. CONCLUSION: Febuxostat, 80 mg or 120 mg, was more effective than allopurinol (300 mg) or placebo, when lowering the serum urate. The safety of febuxostat and allopurinol was comparable.
Allopurinol ; Gout ; Humans ; Incidence ; Thiazoles ; Uric Acid ; Febuxostat

To elucidate the neurotoxic mechanism of methylmercury on cultured bovine oligodendrocytes, neurotoxic effect was estimated by MTT assay after cultures were exposed to various concentrations of methylmercuric chloride (MMC). In addition, neuroprotective effect of antioxidant, allopurinol agonist MMC-induced neurotoxicity was examined on these cultures. Exposure of cultured bovine oligodendrocytes to MMC showed less than 50% of the cell viability 24 hours after treatment with 35µM of MMC. And also, allopurinol blocked the neurotoxicity induced by MMC on these cultures. These results suggest that oxygen radicals involve in MMC-mediated neurotoxicity, and also seletive antioxidants such as allopurinol are effective in blocking the neurotoxicity induced by MMC on cultured bovine oligodendrocytes.
Allopurinol* ; Antioxidants ; Cell Survival ; Neuroprotective Agents ; Oligodendroglia ; Reactive Oxygen Species

Allopurinol is one of the causative drugs that induce fixed drug eruption (FDE). The lymphocyte transformation test (LTT) is a safe and reliable diagnostic procedure for drug allergy, but is reported to be rarely positive in patients with FDE. In the current case, we performed an LTT and successfully confirmed allopurinol as the offending drug. This case report suggests that an LTT should be an optional diagnostic tool for FDE or delayed reaction due to allopurinol.
Allopurinol ; Drug Eruptions ; Drug Hypersensitivity ; Humans ; Lymphocyte Activation ; Lymphocytes