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Examining the use of allopurinol: Perspectives from recent drug injury relief applications
- Source :
- Journal of the Formosan Medical Association, Vol 118, Iss 1, Pp 371-377 (2019)
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background/purpose: Previous studies have reported that the indication and starting dose of allopurinol may be associated with the incidence of hypersensitive reactions. As allopurinol-related severe cutaneous adverse reactions (SCARs) constitute a significant proportion of drug injury relief applications in Taiwan, this study sought to examine allopurinol use and related adverse reactions through an analysis of recent drug injury relief applications. Methods: Allopurinol-related drug injury relief applications from 1999 to 2016 were collected, and descriptive statistical methods were used to analyze recent applications dating from 2011 to 2016. Results: A total of 174 allopurinol-related drug injury relief applications were submitted between 2011 and 2016, with the majority involving cases over the age of 65 (75.3%; mean age of all cases was 69.2). Most allopurinol-related drug injuries concerned the skin (173 out of 174 cases, 99.4%). The majority of cases had other co-morbidities such as cardiovascular disease/hypertension (86.2%), chronic kidney disease (58.6%), or diabetes (46.6%). Over 70% of cases initiated allopurinol at a dose of 100 mg/day or less. Analysis revealed that the greatest number of cases (44.6%) occurred in those with an estimated glomerular filtration rate (eGFR) between 15 and 60 mL/min/1.73 m2 and who initiated allopurinol at a dose of 100 mg/day. Conclusion: Old age and renal dysfunction are key risk factors for allopurinol hypersensitivity. When considering allopurinol for elderly patients with impaired kidney function, a full risk-benefit assessment, dosage adjustments, and careful monitoring may be warranted. Keywords: Allopurinol, Compensation and redress, Drug-induced Stevens-Johnson syndrome, Taiwan, Toxic epidermal necrolysis
- Subjects :
- Adult
Male
medicine.medical_specialty
Allopurinol
Taiwan
Renal function
Comorbidity
Disease
Risk Assessment
Gout Suppressants
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Diabetes mellitus
Diabetes Mellitus
medicine
Humans
Renal Insufficiency, Chronic
Aged
lcsh:R5-920
integumentary system
business.industry
Incidence
Incidence (epidemiology)
Age Factors
General Medicine
Middle Aged
medicine.disease
Toxic epidermal necrolysis
Stevens-Johnson Syndrome
030220 oncology & carcinogenesis
Hypertension
Female
030211 gastroenterology & hepatology
lcsh:Medicine (General)
business
Glomerular Filtration Rate
medicine.drug
Kidney disease
Subjects
Details
- ISSN :
- 09296646
- Volume :
- 118
- Database :
- OpenAIRE
- Journal :
- Journal of the Formosan Medical Association
- Accession number :
- edsair.doi.dedup.....06d05859e119b36def0402cbfdfd2f93