การศึกษาขนาดของ allopurinol ที่เหมาะสมในการรักษาโรคเกาต์

บทคัดย่อ

The management of gouty arthritis involves not only treating acute arthritic inflammation but also lowering serum urate levels for the goal of preventing recurrent disease and progression in long-term or prophylactic therapy. Allopurinol is the most frequently used antihyperuricemic agent, probably because of its convenient once-daily regimen and its efficacy. We conducted a prospective study of 88 patients, at the outpatient division at Damnoensaduak Hospital. Alter definite diagnosis and no clinical of acute arthritis, allopurinol was prescribed at lower dose depended on renal function and titrated the dosage every 4 weeks. A number of acute gouty arthritis, serum uric acid, serum creatinine, completed blood count and liver function test were measured before and after this study period. The result showed 300 mg-conventional dosage of allopurinol was effective for prevent gouty attack only 71.88% and 57.95% in non-tophi and tophaceous patient respectively. Optimal dosage in this study were variably between 100-600 mg. Minor hypersensitivity reaction to allopurinol including maculopapular rashes occured in approximately 2%. There was no serious side effects in this study. In conclusion, 300 mg-conventional dose of alloperinol may be ineffective for prevention of acute gouty arthritis and lowering serum uric acid, especially in chronic tophaceous patient.

The management of gouty arthritis involves not only treating acute arthritic inflammation but also lowering serum urate levels for the goal of preventing recurrent disease and progression in long-term or prophylactic therapy. Allopurinol is the most frequently used antihyperuricemic agent, probably because of its convenient once-daily regimen and its efficacy. We conducted a prospective study of 88 patients, at the outpatient division at Damnoensaduak Hospital. Alter definite diagnosis and no clinical of acute arthritis, allopurinol was prescribed at lower dose depended on renal function and titrated the dosage every 4 weeks. A number of acute gouty arthritis, serum uric acid, serum creatinine, completed blood count and liver function test were measured before and after this study period. The result showed 300 mg-conventional dosage of allopurinol was effective for prevent gouty attack only 71.88% and 57.95% in non-tophi and tophaceous patient respectively. Optimal dosage in this study were variably between 100-600 mg. Minor hypersensitivity reaction to allopurinol including maculopapular rashes occured in approximately 2%. There was no serious side effects in this study. In conclusion, 300 mg-conventional dose of alloperinol may be ineffective for prevention of acute gouty arthritis and lowering serum uric acid, especially in chronic tophaceous patient.