Gout Drug May Protect Against Chronic Kidney Disease.
Gout is the most common inflammatory arthritis in the United States, affecting 3.9 percent of Americans. Allopurinol is the most frequently used medication to manage gout, but physicians have traditionally hesitated to prescribe allopurinol because of concerns about patients developing chronic kidney disease, despite a lack of clear data supporting this relationship.
Now, a new study co-authored by a School of Public Health researcher suggests allopurinol may actually offer protection against the development of kidney disease.
These findings appear in JAMA Internal Medicine.
“We hope these results will be disseminated to PCPs and internists taking care of patients with gout, so that allopurinol is not held or stopped when a patient experiences a creatinine bump,” says Tuhina Neogi, corresponding author of the study and professor of epidemiology.
Fears about kidney disease have led to undertreating many gout patients, leading to poorer gout outcomes, says Neogi, who is also a professor of medicine at the School of Medicine and a rheumatologist at Boston Medicine Center.
For the study, Neogi and her colleagues evaluated kidney function in gout patients after starting allopurinol. They used data from the Health Improvement Network, a general practitioner medical records database representative of the United Kingdom’s general population.
They found that, of the more than 4,000 patients started on full-dose allopurinol for prevention of gout flares, 12.2 percent had developed Stage 3 chronic kidney disease after an average of five years of treatment, as compared to 13.1 percent of non-users over a similar period. The researchers concluded that the use of allopurinol in the management of gout is not only safe, but also potentially beneficial in reducing the risk of kidney disease.
The study was co-authored by Christine Peloquin (SPH’09) and Yuqing Zhang (SPH’93) of the School of Medicine and led by Ana Beatriz Vargas-Santos of the State University of Rio de Janeiro.