Allopurinol to Febuxostat: How far have we come?

2010 ◽  
Vol 2 ◽  
pp. CMT.S6286 ◽  
Author(s):  
Amy L. Stockert ◽  
Melissa Stechschulte
Keyword(s):  
Clinical Study ◽  
Xanthine Oxidase ◽  
Drug Administration ◽  
Clinical Studies ◽  
Adverse Reactions ◽  
Food And Drug Administration ◽  
Alternative Therapy ◽  
Oxidase Inhibitor ◽  
Xanthine Oxidase Inhibitor

For decades allopurinol has been used as a xanthine oxidase inhibitor for treatment of hyperuricemia and gout. Although effective in many patients, some experience sensitivity to the drug. In some cases, this sensitivity may lead to allopurinol hypersensitivity disorder, which if untreated can be fatal. Recently the Food and Drug Administration has approved the use of febuxostat as an alternative therapy for hyperuricemia and gout. Febuxostat is a new xanthine oxidase inhibitor, but is not purine based and therefore decreases adverse reactions due to patient sensitivity. This review is a comprehensive look at the background of hyperuricemia and gout treatment with allopurinol compared to recent clinical studies with febuxostat. Each clinical study is evaluated and summarized, identifying the advances in treatment that have been made as well as the concerns that still exist with either treatment.

scholarly journals Successful febuxostat desensitization in a patient with febuxostat hypersensitivity: A Malaysian experience

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774908 ◽  
Author(s):  
Narisa Sulaiman ◽  
Ahmad Zaidi Othman ◽  
Nor Shuhaila Shahril ◽  
Anna Misyail Abdul Rashid ◽  
Mohamad Syafeeq Faeez Md Noh
Keyword(s):  
Renal Impairment ◽  
Xanthine Oxidase ◽  
Adverse Reactions ◽  
Oxidase Inhibitor ◽  
Cutaneous Reaction ◽  
Xanthine Oxidase Inhibitor ◽  
Lowering Therapy ◽  
History Of

Over the years, allopurinol has been widely used as the preferred choice of urate lowering therapy in patients with gout. However, its role in patients with renal impairment is limited; and adverse reactions are well documented. Febuxostat, a newer oral non-purine xanthine oxidase inhibitor has been proven in several trials to be more effective and tolerable compared to allopurinol and may be used in patients with renal impairment. Here, we describe a case of successful febuxostat desensitization in a patient with a history of allopurinol- and febuxostat-induced adverse cutaneous reaction, as well as the protocol utilized.

Beneficial Effects of Xanthine Oxidase Inhibitor, Topiloxostat, on Experimental Diabetic Neuropathy in Mice

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 549-P
Author(s):  
HIROKI MIZUKAMI ◽  
REMINA KOYAMA ◽  
KAZUHISA TAKAHASHI ◽  
SHO OSONOI ◽  
SAORI OGASAWARA ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Xanthine Oxidase ◽  
Oxidase Inhibitor ◽  
Xanthine Oxidase Inhibitor ◽  
Beneficial Effects ◽  
Experimental Diabetic Neuropathy

Allopurinol and Loss of Consciousness in a 78-old Year Man Suffering from Gout

2020 ◽  
Vol 20 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Mahnaz Arian ◽  
Mina AkbariRad ◽  
Ahmad Bagheri Moghaddam ◽  
Abdollah Firoozi ◽  
Mohammad Jami
Keyword(s):  
Uric Acid ◽  
Xanthine Oxidase ◽  
Kidney Stones ◽  
Oxidase Inhibitor ◽  
Loss Of Consciousness ◽  
Drug Induced ◽  
Xanthine Oxidase Inhibitor ◽  
Case Presentation ◽  
Maculopapular Rashes ◽  
Reduced State

: Allopurinol is an FDA -Approved xanthine oxidase inhibitor, which is effective in the treatment of gout, hyperuricemia and uremic kidney stones in patients with an increased level of uric acid excretion. Xanthine oxidase acts by converting hypoxanthine and xanthine into uric acid, and therefore its inhibition results in decreased production of uric acid. The most common side effects of this medication are as follows: maculopapular rashes, hives, itching, headache, dizziness, abnormal hair loss, fever and hypersensitivity reaction. Case Presentation: This report represents a case of drug-induced meningitis of a senile man who ended up in the ICU due to the remarkably reduced state of consciousness.

scholarly journals Xanthine oxidase inhibitors are associated with reduced risk of cardiovascular disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hirotaka Saito ◽  
Kenichi Tanaka ◽  
Tsuyoshi Iwasaki ◽  
Akira Oda ◽  
Shuhei Watanabe ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Xanthine Oxidase ◽  
Cardiovascular Events ◽  
Oxidase Inhibitor ◽  
Cardiovascular Risks ◽  
Diabetic Mellitus ◽  
Xanthine Oxidase Inhibitor ◽  
Xanthine Oxidase Inhibitors ◽  
Reduced Risk

AbstractAs previous studies have reported finding an association between hyperuricemia and the development of cardiovascular and chronic kidney disease, hyperuricemia is thought to be an independent risk factor for hypertension and diabetic mellitus. However, we have not been able to determine whether the use of xanthine oxidase inhibitors can reduce cardiovascular disease. The present study used the longitudinal data of the Fukushima Cohort Study to investigate the relationship between the use of xanthine oxidase inhibitors and cardiovascular events in patients with cardiovascular risks. During the 3-year period between 2012 and 2014, a total of 2724 subjects were enrolled in the study and followed. A total of 2501 subjects had hypertension, diabetic mellitus, dyslipidemia, or chronic kidney disease, and were identified as having cardiovascular risks. The effects of xanthine oxidase inhibitor use on the development of cardiovascular events was evaluated in these patients using a time to event analysis. During the observational periods (median 2.7 years), the incidence of cardiovascular events was 20.7 in subjects with xanthine oxidase inhibitor and 11.2 (/1000 person-years, respectively) in those without. Although a univariate Cox regression analysis showed that the risk of cardiovascular events was significantly higher in subjects administered xanthine oxidase inhibitors (HR = 1.87, 95% CI 1.19–2.94, p = 0.007), the risk was significantly lower in subjects administered a xanthine oxidase inhibitor after adjustment for covariates (HR = 0.48, 95% CI 0.26–0.91; p = 0.024) compared to those without. Xanthine oxidase inhibitor use was associated with reduced risk of cardiovascular disease in patients with cardiovascular risk factors.

scholarly journals The xanthine oxidase inhibitor oxypurinol does not limit infarct size in a canine model of 40 minutes of ischemia with reperfusion

1988 ◽  
Vol 12 (1) ◽  
pp. 209-217 ◽  
Author(s):  
James M Kinsman ◽  
Charles E Murry ◽  
Vincent J Richard ◽  
Robert B Jennings ◽  
Keith A Reimer
Keyword(s):  
Infarct Size ◽  
Xanthine Oxidase ◽  
Canine Model ◽  
Oxidase Inhibitor ◽  
Xanthine Oxidase Inhibitor

Fluorometric determination of uric acid in bovine milk

2010 ◽  
Vol 77 (4) ◽  
pp. 438-444 ◽  
Author(s):  
Torben Larsen ◽  
Kasey M Moyes
Keyword(s):  
Heat Treatment ◽  
Uric Acid ◽  
Xanthine Oxidase ◽  
Bovine Milk ◽  
Oxidase Inhibitor ◽  
Enzymatic Oxidation ◽  
Fast Method ◽  
Xanthine Oxidase Inhibitor ◽  
Milk Samples

The primary objective of this study is to validate a new fast method for determination of uric acid in milk. The method is based on an enzymatic-fluorometric technique that requires minimal pre-treatment of milk samples. The present determination of uric acid is based on the enzymatic oxidation of uric acid to 5-hydroxyisourate via uricase where the liberated hydrogen peroxide reacts with 10-acetyl-3,7-dihydroxyphenoxazine via peroxidase and the fluorescent product, resorufin, is measured fluorometrically. Fresh composite milk samples (n=1,072) were collected from both Jersey (n=38) and Danish Holstein (n=106) cows from one local herd. The average inter- and intra-assay variations were 7·1% and 3·0%, respectively. Percent recovery averaged 103·4, 107·0 and 107·5% for samples spiked with 20, 40 or 60 μmof standard, respectively, with a correlation (r=0·98;P<0·001) observed between the observed and expected uric acid concentrations. A positive correlation (r=0·96;P<0·001) was observed between uric acid concentrations using the present method and a reference assay. Storage at 4°C for 24 h resulted in lower (P<0·01) uric acid concentrations in milk when compared with no storage or samples stored at −18°C for 24 h. Addition of either allopurinol (a xanthine oxidase inhibitor) or dimethylsulfoxide (a solvent for allopurinol) did not affect milk uric acid concentrations (P=0·96) and may indicate that heat treatment before storage and analysis was sufficient to degrade xanthine oxidase activity in milk. No relationship was observed between milk uric acid and milk yield and milk components. Authors recommend a single heat treatment (82°C for 10 min) followed by either an immediate analysis of fresh milk samples or storage at −18°C until further analysis.

*Xanthine Oxidase Inhibitor in Acute Experimental Pancreatitis in Rats and Mice

Pancreas ◽  
1989 ◽  
Vol 4 (4) ◽  
pp. 436-440 ◽  
Author(s):  
Paul Georg Lankisch ◽  
Uwe Pohl ◽  
Jutta Otto ◽  
Urszula Wereszczynska-Siemiatkowska ◽  
Hermann-Josef Gröne
Keyword(s):  
Xanthine Oxidase ◽  
Oxidase Inhibitor ◽  
Experimental Pancreatitis ◽  
Xanthine Oxidase Inhibitor ◽  
Acute Experimental Pancreatitis ◽  
Rats And Mice
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