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Impact of allopurinol use on urate concentration and cardiovascular outcome

AIMS: To characterize patients with urate measurements by urate-lowering therapy (ULT) use and to study the impact of allopurinol treatment on cardiovascular and mortality outcomes. METHODS: A cohort study using a record-linkage database. The study included 7135 patients aged ≥60 years with urate me...

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Autores principales: Wei, Li, Mackenzie, Isla S, Chen, Yang, Struthers, Allan D, MacDonald, Thomas M
Formato: Texto
Lenguaje:English
Publicado: Blackwell Science Inc 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080649/
https://www.ncbi.nlm.nih.gov/pubmed/21395653
http://dx.doi.org/10.1111/j.1365-2125.2010.03887.x
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author Wei, Li
Mackenzie, Isla S
Chen, Yang
Struthers, Allan D
MacDonald, Thomas M
author_facet Wei, Li
Mackenzie, Isla S
Chen, Yang
Struthers, Allan D
MacDonald, Thomas M
author_sort Wei, Li
collection PubMed
description AIMS: To characterize patients with urate measurements by urate-lowering therapy (ULT) use and to study the impact of allopurinol treatment on cardiovascular and mortality outcomes. METHODS: A cohort study using a record-linkage database. The study included 7135 patients aged ≥60 years with urate measurements between 2000 and 2002 followed up until 2007. A Cox regression model was used. The association between urate levels, dispensed allopurinol and cardiovascular hospitalization and mortality was determined. RESULTS: Six thousand and forty-two patients were not taking ULT and 45.9% of those (2774 of 6042) had urate concentrations ≤6 mg dl(−1). Among 1035 allopurinol users, 44.7% (45.6% for men and 43.3% for women) reached target urate concentration. There was no significant increased risk of cardiovascular events for allopurinol users when compared with non-ULT users [adjusted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.95–1.26] and the non-ULT group with urate >6 mg dl(−1) (adjusted HR 1.07, 95% CI 0.89–1.28). Within the allopurinol use cohort, cardiovascular event rates were 74.0 (95% CI 61.9–86.1) per 1000 person years for the 100 mg group, 69.7 (49.6–89.8) for the 200 mg group and 47.6 (38.4–56.9) for the ≥300 mg group. Compared with low-dose (100 mg) users, high-dose (≥300 mg) users had significant reductions in the risk of cardiovascular events (adjusted HR 0.69, 95% CI 0.50–0.94) and mortality (adjusted HR 0.75, 95% CI 0.59–0.94). CONCLUSIONS: Less than 50% of patients taking allopurinol reached target urate concentration. Higher doses of allopurinol were associated with better control of urate and lower risks of both cardiovascular events and mortality.
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spelling pubmed-30806492011-05-13 Impact of allopurinol use on urate concentration and cardiovascular outcome Wei, Li Mackenzie, Isla S Chen, Yang Struthers, Allan D MacDonald, Thomas M Br J Clin Pharmacol Pharmacoepidemiology AIMS: To characterize patients with urate measurements by urate-lowering therapy (ULT) use and to study the impact of allopurinol treatment on cardiovascular and mortality outcomes. METHODS: A cohort study using a record-linkage database. The study included 7135 patients aged ≥60 years with urate measurements between 2000 and 2002 followed up until 2007. A Cox regression model was used. The association between urate levels, dispensed allopurinol and cardiovascular hospitalization and mortality was determined. RESULTS: Six thousand and forty-two patients were not taking ULT and 45.9% of those (2774 of 6042) had urate concentrations ≤6 mg dl(−1). Among 1035 allopurinol users, 44.7% (45.6% for men and 43.3% for women) reached target urate concentration. There was no significant increased risk of cardiovascular events for allopurinol users when compared with non-ULT users [adjusted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.95–1.26] and the non-ULT group with urate >6 mg dl(−1) (adjusted HR 1.07, 95% CI 0.89–1.28). Within the allopurinol use cohort, cardiovascular event rates were 74.0 (95% CI 61.9–86.1) per 1000 person years for the 100 mg group, 69.7 (49.6–89.8) for the 200 mg group and 47.6 (38.4–56.9) for the ≥300 mg group. Compared with low-dose (100 mg) users, high-dose (≥300 mg) users had significant reductions in the risk of cardiovascular events (adjusted HR 0.69, 95% CI 0.50–0.94) and mortality (adjusted HR 0.75, 95% CI 0.59–0.94). CONCLUSIONS: Less than 50% of patients taking allopurinol reached target urate concentration. Higher doses of allopurinol were associated with better control of urate and lower risks of both cardiovascular events and mortality. Blackwell Science Inc 2011-04 /pmc/articles/PMC3080649/ /pubmed/21395653 http://dx.doi.org/10.1111/j.1365-2125.2010.03887.x Text en Copyright © 2011 The British Pharmacological Society
spellingShingle Pharmacoepidemiology
Wei, Li
Mackenzie, Isla S
Chen, Yang
Struthers, Allan D
MacDonald, Thomas M
Impact of allopurinol use on urate concentration and cardiovascular outcome
title Impact of allopurinol use on urate concentration and cardiovascular outcome
title_full Impact of allopurinol use on urate concentration and cardiovascular outcome
title_fullStr Impact of allopurinol use on urate concentration and cardiovascular outcome
title_full_unstemmed Impact of allopurinol use on urate concentration and cardiovascular outcome
title_short Impact of allopurinol use on urate concentration and cardiovascular outcome
title_sort impact of allopurinol use on urate concentration and cardiovascular outcome
topic Pharmacoepidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080649/
https://www.ncbi.nlm.nih.gov/pubmed/21395653
http://dx.doi.org/10.1111/j.1365-2125.2010.03887.x
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