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Difficult gout and new approaches for control of hyperuricemia in the allopurinol-allergic patient
- Source :
- Current Rheumatology Reports. 3:29-35
- Publication Year :
- 2001
- Publisher :
- Springer Science and Business Media LLC, 2001.
-
Abstract
- A major obstacle to the treatment of hyperuricemia in patients allergic to allopurinol is the limited availability of suitable, equally effective, alternative, urate-lowering drugs. Conventional uricosuric drugs, including probenecid and sulfinpyrazone, are recommended for allopurinol- intolerant patients with gout and "underexcretion" hyperuricemia who have normal renal function and no history of nephrolithiasis. Therapeutic options in those in whom traditional uricosuric drugs are contraindicated, ineffective, or poorly tolerated include slow oral desensitization to allopurinol and cautious administration of oxipurinol. Allopurinol desensitization is useful particularly in those who have failed other treatment modalities. If available (as in Europe, South Africa, and Japan), benzbromarone may be tried in patients with gout and mild-to-moderate renal insufficiency. Recombinant urate oxidase can be used in the short-term prophylaxis and treatment of chemotherapy- associated hyperuricemia in patients with lymphoproliferative and myeloproliferative disorders. Hyperuricemia and gout occur with increased frequency in cyclosporine-treated allograft transplant recipients. The management of gout in these patients is complicated by two main factors: cyclosporine-induced renal impairment, and interactions with medications used to preserve the allograft.
- Subjects :
- musculoskeletal diseases
congenital, hereditary, and neonatal diseases and abnormalities
medicine.medical_specialty
Uricosuric
Gout
Allopurinol
Pharmacology
Kidney
Gout Suppressants
Drug Hypersensitivity
Benzbromarone
chemistry.chemical_compound
Rheumatology
Internal medicine
medicine
Humans
Transplantation, Homologous
Hyperuricemia
Oxipurinol
business.industry
nutritional and metabolic diseases
Uricosuric Agents
medicine.disease
Uric Acid
Probenecid
chemistry
Sulfinpyrazone
business
medicine.drug
Subjects
Details
- ISSN :
- 15346307 and 15233774
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Current Rheumatology Reports
- Accession number :
- edsair.doi.dedup.....0287b1c045e6292f7c6933398350dd0e