ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Heart disease and the risk of allopurinol-associated severe cutaneous adverse reactions: a general population-based cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 27 citations in OpenAlex.
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- Balancing Stone Prevention and Kidney Function: A Therapeutic Dilemma.Journal of clinical medicine · 2025Review
- Traditional Chinese Medicine is Associated with the Reduction in Endpoint Events in Patients with Gouty Arthritis: Cohort Study and Association Rule Analysis.International journal of general medicine · 2024Article
- Article
- Females present higher dose-adjusted drug concentrations of metoprolol and allopurinol/oxypurinol than males.Clinical and translational science · 2023Article
- Allopurinol hypersensitivity syndrome.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Integrated Molecular Docking with Network Pharmacology to Reveal the Molecular Mechanism of Simiao Powder in the Treatment of Acute Gouty Arthritis.Evidence-based complementary and alternative medicine : eCAM · 2021Article
- Prevention of allopurinol-associated adverse cutaneous drug reactions in high-risk patient groups in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- Allopurinol-Induced DRESS Syndrome in Patients with Pre-Existing Chronic Kidney Disease: A Case Report and Comprehensive Literature Review.Case reports in dermatologyArticle
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9 authors at 1 institution in 2 countries.
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Abstract
backgroundAllopurinol is commonly prescribed for gout, and its clinical use may expand with ongoing trials assessing its potential cardiorenal benefits. Because heart disease has been suggested to be a risk factor for allopurinol-associated severe cutaneous adverse reactions, we sought to confirm this association in a Canadian general population cohort.
methodsWe used population data from British Columbia, Canada, to identify all incident allopurinol users between 1997 and 2015. We examined the association between heart disease (ischemic heart disease and heart failure) and the risk of hospital admission for severe cutaneous adverse reactions, adjusting for known and purported risk factors. We also evaluated the joint effects of combined clinical and demographic risk factors.
resultsAmong 130 325 allopurinol initiators, 109 hospital admissions occurred for allopurinol-associated severe cutaneous adverse reactions. The multivariable relative risk among those with heart disease was 1.55 (95% confidence interval 1.01-2.37). Patients with heart disease and chronic kidney disease who were started on an allopurinol dosage of greater than 100 mg/d had an 11-fold higher risk. Allopurinol initiation at a lower dosage among patients with heart disease and chronic kidney disease resulted in a fivefold reduction in risk. Older women with heart disease from regions with large Asian populations had a 23-fold higher risk of allopurinol-associated severe cutaneous adverse reactions than younger men without heart disease from other regions.
interpretationHeart disease is independently associated with risk of allopurinol-associated severe cutaneous adverse reactions, similar to chronic kidney disease, and low-dosage allopurinol initiation may substantially mitigate this risk. Risk factors for these rare but serious reactions should be considered when initiating allopurinol.
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