Evidence map›Paper›PMID 30446002›Full record

Trial reportArthritis research & therapy2018

How much allopurinol does it take to get to target urate? Comparison of actual dose with creatinine clearance-based dose.

Lisa K Stamp, Peter T Chapman, Murray L Barclay, Anne Horne, Christopher Frampton, Paul Tan, Jill Drake, Nicola Dalbeth

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Arthritis research & therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Better outcomes for patients with gout.Inflammopharmacology · 2020
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Lisa K StampDepartment of Medicine, University of Otago, Christchurch, P. O. Box 4345, Christchurch, 8140, New Zealand. lisa.stamp@cdhb.health.nz.
Peter T ChapmanDepartment of Rheumatology, Immunology and Allergy, Christchurch Hospital, Private Bag 4710, Christchurch, 8140, New Zealand.
Murray L BarclayDepartment of Medicine, University of Otago, Christchurch, P. O. Box 4345, Christchurch, 8140, New Zealand.
Anne HorneDepartment of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Christopher FramptonDepartment of Medicine, University of Otago, Christchurch, P. O. Box 4345, Christchurch, 8140, New Zealand.
Paul TanDepartment of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Jill DrakeDepartment of Medicine, University of Otago, Christchurch, P. O. Box 4345, Christchurch, 8140, New Zealand.
Nicola DalbethDepartment of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand.
University of Auckland · NZUniversity of Otago · NZChristchurch Hospital · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAllopurinol dosing has frequently been limited based on creatinine clearance (CrCL), resulting in failure to achieve target serum urate (SU). The aim of this analysis was to determine how many milligrams of allopurinol above the recommended CrCL-based dose (R+) are required to achieve target SU and to investigate the factors that influence R+.

methodsWe analysed data from participants in a 24-month open, randomized, controlled, parallel-group, comparative clinical trial. Data obtained during the 12-month dose escalation (DE) phase of the study (year 1 for DE/DE and year 2 for control/DE) were combined. R+ dose was defined as the number of milligrams of allopurinol above the CrCL-based dose at the final visit.

resultsOf the 132 participants, R+ allopurinol dose at the final visit was ≤ 100 mg/day in 38 (28.8%), 101-200 mg/day in 46 (34.8%) and > 200 mg/day in 48 participants (37.1%). There was no significant difference between the R+ groups in the number of participants achieving target SU. There was an increase in plasma oxypurinol and a larger percentage and absolute change in SU as R+ increased. Multivariate analysis revealed CrCL, weight, baseline SU and allopurinol dose, were significantly positively associated with allopurinol dose at 12 months. There were no significant differences across R+ groups in renal or liver function adverse events, although there were numerically more serious adverse events in the higher R+ groups.

conclusionA wide range of R+ doses are required to achieve target SU. Four easily obtained clinical variables (baseline SU, CrCL, weight, and allopurinol dose) may be helpful to predict allopurinol dose.

trial registrationANZCTR, ACTRN12611000845932 . Registered on 10 August 2011.

Indexed as

AdultAgedAllopurinolCreatinineDose-Response Relationship, DrugDrug Delivery SystemsFemaleGoutGout SuppressantsHumansMaleMetabolic Clearance RateMiddle AgedUric AcidAllopurinolCreatinineGout SuppressantsUric Acid

Identifiers

PMID30446002
PMCPMC6240322
OpenAlexW2901701783

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.