Evidence mapPaperPMID 36864979Full record

ArticleEClinicalMedicine2023

Xanthine oxidase inhibition and white matter hyperintensity progression following ischaemic stroke and transient ischaemic attack (XILO-FIST): a multicentre, double-blinded, randomised, placebo-controlled trial.

Jesse Dawson, Michele Robertson, David Alexander Dickie, Phillip Bath, Kirsten Forbes, Terence Quinn, Niall M Broomfield, Krishna Dani, Alex Doney, Graeme Houston and 19 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in EClinicalMedicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02122718 (Xanthine Oxidase Inhibition for Improvement of Long-term Outcomes Following Ischaemic Stroke and Transient Ischaemic Attack), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 14% 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.

NCT02122718 phase4completednot on this map

Xanthine Oxidase Inhibition for Improvement of Long-term Outcomes Following Ischaemic Stroke and Transient Ischaemic Attack

TypeinterventionalSponsorNHS Greater Glasgow and ClydeRan2014 to 2021Enrolled464ConditionsIschaemic StrokeArmsAllopurinol, Placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Change in Cognition Following Ischaemic Stroke.Annals of clinical and translational neurology · 2026
    Trial
  2. Trial
  3. Article
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  5. Review
  6. 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

29 authors at 19 institutions in 1 country.

Jesse DawsonSchool of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
Michele RobertsonRobertson Centre for Biostatistics, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK.
David Alexander DickieSchool of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
Phillip BathStroke Trials Unit, Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
Kirsten ForbesDepartment of Neuroradiology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.
Terence QuinnSchool of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Niall M BroomfieldDepartment of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, NR4 7TJ, UK.
Krishna DaniDepartment of Neurology, Institute of Neurological Sciences Glasgow, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.
Alex DoneyMedicine Monitoring Unit (MEMO), School of Medicine, University of Dundee. Ninewells Hospital, Dundee, DD1 9SY, UK.
Graeme HoustonDivision of Imaging and Science Technology, School of Medicine, Ninewells Hospital, Dundee, DD1 9SY, UK.
Kennedy R LeesSchool of Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK.
Keith W MuirSchool of Psychology and Neuroscience, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
Allan StruthersDivision of Molecular and Clinical Medicine, University of Dundee, UK.
Matthew WaltersSchool of Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK.
Mark BarberUniversity Department of Stroke Care, University Hospital Monklands, Airdrie, ML6 OJS, UK.
Ajay BhallaDepartment of Stroke, Ageing and Health, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK.
Alan CameronSchool of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
Alexander DykerWolfson Unit of Clinical Pharmacology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
Paul GuylerDepartment of Stroke Medicine, Mid and South Essex University Hospitals Group, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK.
Ahamad HassanDepartment of Neurology, Leeds General Infirmary, Leeds, UK.
Mark T KearneyLeeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Leeds, UK.
Breffni KeeganDepartment of Medicine, South West Acute Hospital, Enniskillen, BT74 6DN, UK.
Sekaran LakshmananDepartment of Stroke Medicine The Luton and Dunstable University Hospital, Bedfordshire, NHSFT, Lewsey Road, Luton, LU4 0DZ, UK.
Mary Joan MacleodInstitute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Marc RandallDepartment of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Louise ShawDepartment of Stroke Medicine, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK.
Ganesh SubramanianDepartment of Stroke Medicine, Nottingham University Hospitals, Nottingham, NG5 1PB, UK.
David WerringStroke Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Alex McConnachieRobertson Centre for Biostatistics, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK.
Queen Elizabeth University Hospital · GBUniversity of Glasgow · GBUniversity of Dundee · GBGlasgow Royal Infirmary · GBLeeds General Infirmary · GBLeeds Teaching Hospitals NHS Trust · GBLuton and Dunstable Hospital · GBMonklands Hospital · GBNinewells Hospital · GBNottingham University Hospitals NHS Trust · GBRoyal United Hospital · GBRoyal Victoria Infirmary · GBSouthend University Hospital NHS Foundation Trust · GBSt Thomas' Hospital · GBUniversity College Hospital · GBUniversity of Aberdeen · GBUniversity of East Anglia · GBUniversity of Leeds · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: People who experience an ischaemic stroke are at risk of recurrent vascular events, progression of cerebrovascular disease, and cognitive decline. We assessed whether allopurinol, a xanthine oxidase inhibitor, reduced white matter hyperintensity (WMH) progression and blood pressure (BP) following ischaemic stroke or transient ischaemic attack (TIA). Methods: In this multicentre, prospective, randomised, double-blinded, placebo-controlled trial conducted in 22 stroke units in the United Kingdom, we randomly assigned participants within 30-days of ischaemic stroke or TIA to receive oral allopurinol 300 mg twice daily or placebo for 104 weeks. All participants had brain MRI performed at baseline and week 104 and ambulatory blood pressure monitoring at baseline, week 4 and week 104. The primary outcome was the WMH Rotterdam Progression Score (RPS) at week 104. Analyses were by intention to treat. Participants who received at least one dose of allopurinol or placebo were included in the safety analysis. This trial is registered with ClinicalTrials.gov, NCT02122718. Findings: Between 25th May 2015 and the 29th November 2018, 464 participants were enrolled (232 per group). A total of 372 (189 with placebo and 183 with allopurinol) attended for week 104 MRI and were included in analysis of the primary outcome. The RPS at week 104 was 1.3 (SD 1.8) with allopurinol and 1.5 (SD 1.9) with placebo (between group difference -0.17, 95% CI -0.52 to 0.17, p = 0.33). Serious adverse events were reported in 73 (32%) participants with allopurinol and in 64 (28%) with placebo. There was one potentially treatment related death in the allopurinol group. Interpretation: Allopurinol use did not reduce WMH progression in people with recent ischaemic stroke or TIA and is unlikely to reduce the risk of stroke in unselected people. Funding: The British Heart Foundation and the UK Stroke Association.

Indexed as

AllopurinolHypertensionStrokeWhite matter hyperintensities

Identifiers

PMID36864979
PMCPMC9972492
OpenAlexW4321016004

What Socratic holds

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LicenceCC BY
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Registered trials

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.