Trial reportArthritis research & therapy2017
The effect of kidney function on the urate lowering effect and safety of increasing allopurinol above doses based on creatinine clearance: a post hoc analysis of a randomized controlled trial.
Trial report in Arthritis research & therapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 35 citations in OpenAlex.
- Controversies in Urate-Lowering Therapy for Gout: A Comprehensive Review.Gout, urate, and crystal deposition disease · 2025Article
- Gout therapy updated.Therapeutic advances in musculoskeletal disease · 2025Review
- A Genome-Wide Association Study of Oxypurinol Concentrations in Patients Treated with Allopurinol.Journal of personalized medicine · 2024Article
- The Hong Kong Society of Rheumatology consensus recommendations for the management of gout.Clinical rheumatology · 2023Review
- HLA-A*24:02 increase the risk of allopurinol-induced drug reaction with eosinophilia and systemic symptoms in HLA-B*58:01 carriers in a Korean population; a multicenter cross-sectional case-control study.Clinical and translational allergy · 2022Article
- Efficacy of Xanthine Oxidase Inhibitors in Lowering Serum Uric Acid in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- Management of gout in chronic kidney disease: a G-CAN Consensus Statement on the research priorities.Nature reviews. Rheumatology · 2021Review
- Characteristics, Comorbidities, and Potential Consequences of Uncontrolled Gout: An Insurance-Claims Database Study.Rheumatology and therapy · 2021Article
- Contentious Issues in Gout Management: The Story so Far.Open access rheumatology : research and reviews · 2021Review
- Efficacy and safety of urate-lowering therapy in people with kidney impairment: a GCAN-initiated literature review.Rheumatology advances in practice · 2021Review
- Musculoskeletal Pain in Older Adults: A Clinical Review.The Medical clinics of North America · 2020Review
- Restricting maintenance allopurinol dose according to kidney function in patients with gout is inappropriate!British journal of clinical pharmacology · 2019Article
- Reply to "Restricting maintenance allopurinol dose according to kidney function in patients with gout is inappropriate!" by Stamp et al.British journal of clinical pharmacology · 2019Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of allopurinol in people with chronic kidney disease (CKD) remains one of the most controversial areas in gout management. The aim of this study was to determine the effect of baseline kidney function on safety and efficacy of allopurinol dose escalation to achieve serum urate (SU) <6 mg/dl.
methodsWe undertook a post hoc analysis of a 24-month allopurinol dose escalation treat-to-target SU randomized controlled trial, in which 183 people with gout were randomized to continue current dose allopurinol for 12 months and then enter the dose escalation phase or to begin allopurinol dose escalation immediately. Allopurinol was increased monthly until SU was <6 mg/dl. The effect of baseline kidney function on urate lowering and adverse effects was investigated.
resultsIrrespective of randomization, there was no difference in the percentage of those with creatinine clearance (CrCL) <30 ml/min who achieved SU <6 mg/dl at the final visit compared to those with CrCL ≥30 to <60 ml/min and those with CrCL ≥60 ml/min, with percentages of 64.3% vs. 76.4% vs. 75.0%, respectively (p = 0.65). The mean allopurinol dose at month 24 was significantly lower in those with CrCL <30 ml/min as compared to those with CrCL ≥30 to <60 ml/min or CrCL ≥60 ml/min (mean (SD) 250 (43), 365 (22), and 460 (19) mg/day, respectively (p < 0.001)). Adverse events were similar among groups.
conclusionsAllopurinol is effective at lowering urate even though and accepting that there were small numbers of participants with CrCL <30 ml/min, these data indicate that allopurinol dose escalation to target SU is safe in people with severe CKD. The dose required to achieve target urate is higher in those with better kidney function.
trial registrationAustralian and New Zealand Clinical trials Registry, ACTRN12611000845932 . Registered on 10 August 2011.
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