dc.contributor.author |
Becker, MA |
en |
dc.contributor.author |
Fitz-Patrick, D |
en |
dc.contributor.author |
Choi, HK |
en |
dc.contributor.author |
Dalbeth, Nicola |
en |
dc.contributor.author |
Storgard, C |
en |
dc.contributor.author |
Cravets, M |
en |
dc.contributor.author |
Baumgartner, S |
en |
dc.date.accessioned |
2015-08-20T04:43:04Z |
en |
dc.date.issued |
2015-05 |
en |
dc.identifier.citation |
Seminars in Arthritis and Rheumatism, 2015 |
en |
dc.identifier.issn |
0049-0172 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/26773 |
en |
dc.description.abstract |
OBJECTIVES: Allopurinol is the most widely prescribed serum uric acid-lowering therapy (ULT) in gout. To achieve serum uric acid (sUA) concentrations associated with clinical benefit, allopurinol is serially uptitrated with sUA monitoring. Suboptimal dosing is a key contributor to poor clinical outcomes, but few data are available on the safety and efficacy of dose-titrated allopurinol, particularly at doses >300mg/d. The objective of this open-label study was to investigate the safety and efficacy of allopurinol under conditions where investigators were encouraged to titrate to optimal, medically appropriate doses. METHODS: Long-term Allopurinol Safety Study Evaluating Outcomes in Gout Patients (LASSO) was a large, 6-month, multicenter study of allopurinol (NCT01391325). Adults meeting American Rheumatism Association Criteria for Classification of Acute Arthritis of Primary Gout and ≥2 gout flares in the previous year were eligible. Investigators were encouraged (but not required) to titrate allopurinol doses to achieve target sUA < 6.0mg/dL. The primary objective was evaluation of the safety of dose-titrated allopurinol by clinical and laboratory examinations at monthly visits. Secondary objectives included sUA-lowering efficacy and gout flare frequency. RESULTS: Of 1735 patients enrolled, 1732 received ≥1 allopurinol doses. The maximal daily allopurinol dose during study was <300mg in 14.4%, 300mg in 65.4%, and >300mg in 20.2% of patients; dosing duration was 115.5, 152.0, and 159.7 days, respectively. Overall, baseline demographic characteristics and comorbidity rates were similar across these three categories, but patients receiving >300-mg maximal dose had more severe gout. Treatment-emergent adverse events possibly related to allopurinol occurred in 15.2%, 9.5%, and 11.4% of patients in the <300-, 300-, and >300-mg categories, respectively. Rash incidence was low (1.5%) and allopurinol hypersensitivity syndrome was not reported. No clinically meaningful changes occurred in laboratory values. sUA < 6.0mg/dL at month 6 was achieved by 35.9% of patients overall: 22.4%, 35.0%, and 48.3% in dosing categories <300, 300, and >300mg, respectively. CONCLUSIONS: This large multicenter study found that the allopurinol dose-titration strategy was well tolerated, without new safety signals emerging over 6 months. However, despite encouragement to treat to target, significant proportions of patients did not achieve target sUA. |
en |
dc.language |
English |
en |
dc.publisher |
Elsevier / W. B. Saunders |
en |
dc.relation.ispartofseries |
Seminars in Arthritis and Rheumatism |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/0049-0172/
http://www.elsevier.com/about/company-information/policies/copyright |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
An open-label, 6-month study of allopurinol safety in gout: The LASSO study |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1016/j.semarthrit.2015.05.005 |
en |
dc.rights.holder |
Copyright:
Elsevier / W. B. Saunders |
en |
dc.identifier.pmid |
26190562 |
en |
pubs.author-url |
http://www.sciencedirect.com/science/article/pii/S0049017215001110 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Journal Article |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
491973 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
en |
dc.identifier.eissn |
1532-866X |
en |
pubs.record-created-at-source-date |
2015-08-20 |
en |
pubs.dimensions-id |
26190562 |
en |