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Allopurinol and mortality in hyperuricaemic patients
Rheumatology, 05/19/09

Luk AJ et al. – Findings indicate that allopurinol (the most commonly used urate-lowering drug) treatment may provide a survival benefit among patients with hyperuricaemia.

Methods

Aim was to examine the impact of allopurinol on the risk of mortality in hyperuricaemic pts
A population of hyperuricaemic veterans; ≥40 yrs
Risk of death between incident allopurinol users (n=2483) and non-users (n=7441) was compared
Multivariate mortality hazard ratio (HR) of allopurinol use with Cox proportional hazards models

Results

9924 veterans (98% male, and mean age 62.7 yrs), 1021 died during the f/u
Pts who began treatment with allopurinol had worse prognostic factors for mortality, including higher BMI and comorbidities
After adjusting for baseline urate levels, allopurinol treatment was associated with a lower risk of all-cause mortality
Further adjustment with other prognostic factors did not appreciably alter this estimate
Mean change from baseline in serum urate within the allopurinol group was –111 µmol/l
Adjusting for baseline urate level, allopurinol users had a 40 µmol/l lower f/u serum urate value than controls

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