AB1046 Allopurinol use in chronic kidney disease- is there a difference in achieving target uric acid?- a retrospective study

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1638
• Main Authors: Mehta, V.R., Peredo-Wende, R.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Allopurinol; Glomerular filtration rate; Gout; Hypersensitivity; Kidney diseases; Kidney stones; Kidneys; Uric acid
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.7563

BackgroundPatients with gout are recommended to treat to target uric acid level of 6 mg/dL in absence of tophi, and <5 mg/dL if tophi present. A case-controlled retrospective analysis by Stamp et al of allopurinol hypersensitivity reaction confirmed that the highest risk of severe hypersensitivity reaction is in the first few months of therapy and thus a low starting dose is recommended (as low as 50 mg in stage 4 chronic kidney disease and worse). Due to concerns related to adverse effects from Allopurinol, we hypothesised that allopurinol use would be less aggressive in terms of achieving target uric acid.ObjectivesWe aim to compare the frequency of achieving target uric acid level in patients with glomerular filtration rate (GFR) of less than 60 and more than 60.MethodsWe reviewed charts of patients in a large private practice who were prescribed Allopurinol. Patients who had at least atleast two office visits and had been on Allopurinol at least six months were included in the study. Charts were reviewed of patients for uric acid level, Allopurinol dose, GFR and any major adverse events. Major allopurinol related adverse event was defined as any adverse event leading to hospitalisation or cessation of medication.ResultsMean Allopurinol dose for patients with GFR of more than 60 was 244. There were no major adverse events and 52 out of total 103 patients (50.5%) had achieved goal uric acid.Mean Allopurinol dose for patients with GFR of less than 60 was 238. There were no major adverse events and 19 out of total 38 patients (50%) had achieved goal uric acid.ConclusionsThere was no difference noted in patient with GFR less than 60 or more than 60 in terms of achieving goal uric acid level. No major adverse events were noted in either group.Disclosure of InterestNone declared