allopurinol / Generic mfg. - LARVOL DELTA

Trial of Chemotherapy in Patients With Relapsed Small Cell Lung Cancer Combined With Allopurinol and Mycophenolate (CLAMP) (IASLC-WCLC 2025) - "Mycophenolate mofetil (MMF) directly inhibits purine synthesis via IMPDH inhibition and allopurinol limits purine salvage via inhibition of xanthine oxidase. Conclusions : Despite the preliminary evidence of encouraging activity, the combination of irinotecan, MMF, and allopurinol in patients with relapsed ES-SCLC was associated with increased toxicity, most commonly diarrhea. Future studies should explore a more tolerable cytotoxic drug to synergize with inhibitors of purine metabolism."

Clinical • IO biomarker • Anemia • Lung Cancer • Neutropenia • Oncology • Small Cell Lung Cancer • Solid Tumor • MYC

When Newly Diagnosed Cirrhosis Conceals Cancer: Diagnosing CLL in a Patient With Alcohol Use Disorder, Lymphocytic Ascites, and Exudative Pleural Effusions (ACG 2025) - "Peripheral smear revealed reactive lymphocytes, and lymph node biopsy confirmed Rai stage IV CLL/SLL.Given his decompensated cirrhosis, which precluded standard CLL induction regimens, and concurrent AKI with hyperuricemia concerning for spontaneous tumor lysis, he was started on weekly rituximab monotherapy for disease debulking, along with allopurinol and rasburicase. Prominent paraesophageal, mesenteric, retroperitoneal, bilateral pelvic sidewall, and inguinal lymphadenopathy. Additional findings include mild omental stranding concerning for a neoplastic process, diffuse soft tissue anasarca, and a moderate right-sided pleural effusion with associated passive lung collapse."

Clinical • Pleural effusion • Addiction (Opioid and Alcohol) • Chronic Lymphocytic Leukemia • CNS Disorders • Fibrosis • Hematological Malignancies • Hepatology • Hodgkin Lymphoma • Immunology • Infectious Disease • Leukemia • Liver Failure • Lymphoma • Metabolic Disorders • Non-Hodgkin’s Lymphoma • Oncology • Portal Hypertension • Respiratory Diseases • Small Lymphocytic Lymphoma • Tuberculosis

Therapeutic Drug Monitoring and Pharmacogenomics of Thiopurines in Inflammatory Bowel Disease: International Guidelines Revisited. (PubMed, Ther Drug Monit) - "There is substantial variability in the global TDM and pharmacogenomic practices for thiopurines in IBD. Limited recommendations for NUDT15 testing and disparities in resource availability have contributed to inconsistent clinical implementation. Future guidelines should address these gaps by integrating cost-effective pharmacogenomic strategies and incorporating alternative monitoring methods such as DNA-TG for NUDT15 variants. This review highlights the variability in the global recommendations for thiopurine TDM and pharmacogenomics. To optimize thiopurine therapy and reduce toxicity risks, future guidelines should include NUDT15 testing and consider TG, low-dose thiopurine, and allopurinol treatments."

Biomarker • Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • NUDT15

Uric Acid and Preeclampsia: Pathophysiological Interactions and the Emerging Role of Inflammasome Activation. (PubMed, Antioxidants (Basel)) - "Experimental studies indicate that targeting UA metabolism or inhibiting NLRP3 activation, using agents such as allopurinol, metformin, or MCC950, can mitigate the clinical and histopathological features of PE. These findings support the dual role of UA as both a biomarker and a potential therapeutic target in the management of the disease."

Journal • Review • Cardiovascular • Gynecology • Hypertension • Inflammation • Obstetrics • Renal Disease • IL18 • IL1B • NLRP3

A Study of Dotinurad Versus Allopurinol in Tophaceous Gout (clinicaltrials.gov) - P3 | N=250 | Recruiting | Sponsor: Crystalys Therapeutics | Trial completion date: Oct 2027 ➔ Dec 2027 | Trial primary completion date: Sep 2027 ➔ Dec 2027

Trial completion date • Trial primary completion date • Gout • Inflammatory Arthritis • Rheumatology

A Study of Dotinurad Versus Allopurinol in Participants With Gout (clinicaltrials.gov) - P3 | N=500 | Recruiting | Sponsor: Crystalys Therapeutics | Trial primary completion date: Aug 2027 ➔ Nov 2027

Trial primary completion date • Gout • Inflammatory Arthritis • Rheumatology

Comparison of the effect of allopurinol and febuxostat on 2,8-dihydroxyadenine in plasma and urine: a clinical trial. (PubMed, J Nephrol) - P4 | "The plasma concentration and urinary excretion of DHA decreased markedly on treatment with both study drugs, although febuxostat was more efficacious than allopurinol in both prescribed doses. Trial registration number and date of registration. EudraCT No. 2021-002185-40; https://www.clinicaltrialsregister.eu/ctr-search/search?query=Research+Registry Date on which this record was first entered in the EudraCT database: 2019-03-19."

Clinical • Journal • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease • Urolithiasis

Metabolomic Profiling of Piper sarmentosum Roxb. Extracts Reveals Potent Xanthine Oxidase Inhibition and Anti-inflammatory Effects. (PubMed, J Ethnopharmacol) - "This is the first study to validate the traditional use of Piper sarmentosum for gout using modern metabolomic and pharmacological approaches. The results support its ethnopharmacological role as a natural XO inhibitor and anti-inflammatory agent. Chrysin, in particular, emerges as a promising lead compound. Further studies using monosodium urate-induced gout models and clinical validation are warranted."

Journal • Gout • Inflammation • Inflammatory Arthritis • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain • Rheumatology • IL6

Allopurinol Therapy in Cirrhotic Patients: Impact on Uric Acid and Liver Enzymes (ACG 2025) - "After matching, 5358 patients were included in each group. Allopurinol use was associated with greater reductions in serum uric acid (−2.1 mg/dL vs −0.4 mg/dL, p < 0.01), ALT (−14.2 U/L vs −6.5 U/L), and AST (−12.3 U/L vs −4.8 U/L) compared to controls. Albumin levels increased and total bilirubin decreased in the allopurinol group, though these changes were not statistically significant."

Clinical • Fibrosis • Hepatology • Immunology • Inflammation • Liver Cirrhosis

Allopurinol Use Is Associated With Decreased Incidence of Hepatic Decompensation and Overall Mortality Among Adults With Compensated Cirrhosis: A Population-Based Propensity-Matched Cohort Study of 10,716 Individuals (ACG 2025) - "After propensity-score matching, each group in the any dose exposure included 5358 patients, 2124 in each group for 100 mg, and 1020 in each group for 300 mg. At 18 months, statistically significantly lower incidence of hepatic decompensation was seen in the overall allopurinol exposure cohort (OR: 0.77; 95% CI: 0.70-0.84), the 100 mg cohort (OR: 0.66; 95% CI: 0.57 to 0.76), and 300 mg cohort (OR: 0.76, 95% CI: 0.62 to 0.94). Allopurinol exposure was associated with a decreased incidence of esophageal variceal bleeding (OR: 0.71 95% CI: 0.55 to 0.92), ascites (OR: 0.77 95% CI: 0.69 to 0.84), HE (OR: 0.76 95% CI: 0.63 to 0.92), SBP (OR: 0.61 95% CI: 0.46 to 0.80), and overall mortality (OR: 0.86 95%% CI: 0.77 to 0.96) compared to the control group (Figure). In a propensity-score matched analysis of a large national database, individuals with compensated cirrhosis and allopurinol use had significantly lower risk of hepatic decompensation and overall mortality."

Clinical • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Immunology • Liver Failure • Nephrology • Renal Disease • Solid Tumor

A Potential Unrecognized Risk for Acute Hepatotoxicity: A Case Report of Fulminant Liver Failure Following Recent Initiation of Allopurinol and Colchicine. (PubMed, S D Med) - "Given the temporal relationship between drug initiation and fulminant hepatic failure, this case raises concerns regarding the potential hepatotoxicity of allopurinol and colchicine, particularly in patients with preexisting renal impairment. Increased awareness and early liver function monitoring may be warranted in high-risk patients starting these medications."

Journal • Chronic Kidney Disease • Gout • Hepatology • Inflammatory Arthritis • Liver Failure • Nephrology • Renal Disease • Respiratory Diseases • Rheumatology

The genetics of gout: translation into clinical practice. (PubMed, Ther Adv Musculoskelet Dis) - "The genetic risk variants can also be combined into a genetic risk score to predict outcome in gout. Finally, inherited genetic variants influence response to allopurinol, in particular the p.Gln141Lys variant in ABCG2."

Journal • Review • Gout • Hematological Disorders • Inflammatory Arthritis • Rheumatology • ABCG2 • IL1B • NLRP3

Genotype Frequency of HLA-B*58:01 and Its Association with Paraclinical Characteristics and PSORS1C1 rs9263726 in Gout Patients. (PubMed, Diagnostics (Basel)) - "Background/Objectives: The HLA-B*58:01 allele is strongly linked to severe cutaneous adverse reactions (SCARs) during allopurinol treatment, and it has been associated with the A allele of PSORS1C1 rs9263726 (G>A)...White blood cell counts differed significantly between the *X/HLA-B*58:01 and *X/*X groups in male gout patients. The A allele of PSORS1C1 rs9263726 was not consistently associated with HLA-B*58:01 and was not a reliable marker for its detection in this study population."

Journal • Gout • Inflammatory Arthritis • Rheumatology • HLA-B

Pediococcus acidilactici GR-5 alleviates hyperuricemia by degrading purine nucleosides and improving gut microbiota metabolism. (PubMed, NPJ Sci Food) - "GR-5 may improves tissue inflammatory damage by inhibiting the NLRP3 inflammatory pathway, and restored the intestinal barrier by increasing tight junction proteins Occludin and ZO-1 expression, which outperforming the allopurinol...GR-5 colonization in intestine increased the abundance of Lactobacillus, improved the metabolism of purine, tryptophan and bile acid by gut microbiota, and increased the level of SCFAs. Overall, GR-5 may be a potential preventive agent for improving HUA and is expected to provide a healthy option for preventing diet-induced HUA."

Journal • NLRP3 • OCLN • TJP1

Association of the ABCG2 Q141K variant with gout in Kinh Vietnamese: a cross-sectional study. (PubMed, Clin Rheumatol) - "The ABCG2 Q141K polymorphism significantly increases gout susceptibility among the Kinh Vietnamese population. The high frequency of the A allele in Vietnamese gout patients highlights the potential utility of genetic screening for appropriate preventive strategies. Key Points • The data regarding the contributions of genetic factors in gout of Vietnamese population remain insufficient. • This study showed that the ABCG2 Q141K polymorphism significantly increases gout susceptibility among the Kinh Vietnamese population."

Journal • Observational data • Gout • Immunology • Inflammatory Arthritis • Rheumatology • ABCG2

HLA-B*58:01 genotyping prevalence and the association with allopurinol-induced severe cutaneous adverse reactions: a living systematic review and meta-analysis. (PubMed, Sci Rep) - "We found a higher prevalence of HLA-B*58:01 genotyping in some Asian populations compared with the Whites. There is evidence to confirm a strong association between this allele and allopurinol-induced SCARs."

Journal • Retrospective data • Review • Immunology • HLA-B

HLA-B*58:01 screening in Asia-Pacific is an ethical imperative - not just a cost question. (PubMed, J Glob Health) - "Allopurinol remains the first-line treatment for gout; however, it carries a risk of severe cutaneous adverse reactions (SCARs), particularly among carriers of the HLA-B*58:01 allele...Rapid point-of-care testing and integration of screening process with existing care pathway may further support this implementation. However, a coordinated regional effort is needed to ensure safer prescribing and equitable access to pharmacogenomic screening across diverse healthcare settings."

Journal • Review • Gout • Inflammatory Arthritis • Rheumatology • HLA-B

Lesch-Nyhan syndrome a dental approach: case report. (PubMed, Afr Health Sci) - "Several types of treatments are managed to reduce the manifestations of Lesch-Nyhan Syndrome, such as the placement of oral appliances, dental extractions, and drug therapy, the main one being Allopurinol, which can reduce the concentration of uric acid in the body. The role of the dentist becomes essential since teeth represent the main instrument for self-mutilation. In this sense, the article aims to describe the Lesch-Nyhan syndrome, the possible treatments and report a clinical case of a 4-year-old male patient who presented the syndrome."

Journal • CNS Disorders • Mental Retardation

Diverse Development Approaches for Xanthine Oxidase Inhibitors: Synthetic Chemistry, Natural Product Chemistry, and Drug Repositioning. (PubMed, Curr Med Chem) - "Currently, clinically used xanthine oxidase inhibitors (XODIs), such as allopurinol and febuxostat, are effective but associated with notable side effects. The aim is to provide meaningful insights for the development of new therapeutic agents for gout and hyperuricemia. Notably, amides and carboxylic acids among chemically synthesized compounds exhibit promising prospects, while natural products with multiple mechanisms of uric acid reduction hold significant potential for the treatment of hyperuricemia."

Journal • Cardiovascular • Gout • Immunology • Inflammatory Arthritis • Rheumatology

An Updated Economic Evaluation of HLA-B*58:01 Genotype Testing in Gouty Patients for Preventing Severe Allopurinol Hypersensitivity in Thailand. (PubMed, ACR Open Rheumatol) - "HLA-B*58:01 testing was not cost-effective before allopurinol initiation in Thai patients with gout at the current price of 1,000 THB per test. However, HLA-B*58:01 testing would be cost-effective if only probenecid was the alternative treatment for patients with positive HLA-B*58:01 results. This result would be useful for health authorities, policy decision-makers, and physicians' organizations in providing the recommendation for HLA-B*58:01 testing before initiation of allopurinol."

HEOR • Journal • Gout • Immunology • Inflammatory Arthritis • Rheumatology • Steven-Johnson Syndrome • HLA-B

First report of treatment and short-term follow-up of a European mink (Mustela lutreola) with leishmaniosis in Spain. (PubMed, Res Vet Sci) - "Subsequently, treatment with meglumine antimoniate and allopurinol resulted in a marked clinical response and resolution of the main signs. These findings underscore the need for screening for L.infantum and prompt therapeutic intervention to protect Mustela lutreola populations."

Journal • Dry Eye Disease • Hematological Disorders • Ocular Inflammation • Ophthalmology

Cost-effectiveness of low dose colchicine prophylaxis when starting allopurinol using the "start-low go-slow" approach for gout: evidence from a non-inferiority randomised double-blind placebo-controlled trial. (PubMed, Arthritis Care Res (Hoboken)) - "Six months of low-dose colchicine prophylaxis when starting allopurinol using the "start-low go-slow" approach is unlikely to be cost-effective over 12 months."

Head-to-Head • HEOR • Journal • Gout • Inflammatory Arthritis • Rheumatology

A Study of Dotinurad Versus Allopurinol in Participants With Gout (clinicaltrials.gov) - P3 | N=500 | Recruiting | Sponsor: Crystalys Therapeutics | Not yet recruiting ➔ Recruiting

Enrollment open • Gout • Inflammatory Arthritis • Rheumatology

No role for allopurinol trial as a diagnostic test for gout. (PubMed, Rheumatol Int) - No abstract available

Journal • Gout • Inflammatory Arthritis • Rheumatology

Ischaemic cardiovascular risk with allopurinol and protective effect of colchicine in gout: a Dutch nationwide pharmaco-epidemiological study. (PubMed, Eur J Prev Cardiol) - "Allopurinol initiation was associated with a substantial and dose-dependent increase in CVD risk in gout patients, especially in the first 30-90 days and at dosages ≥300 mg/day. Concomitant colchicine use reduced this risk. Discontinuation of allopurinol was not associated with CVD risk."

Journal • Cardiovascular • Gout • Inflammatory Arthritis • Rheumatology