allopurinol / Generic mfg. - LARVOL DELTA

Anesthetic Considerations in Allopurinol-Induced DRESS Requiring Liver Transplant: A Case Report (ASA 2025) - "He was listed as a Status 1a and successfully underwent a deceased donor transplant. Here, we focus on the anesthetic considerations in managing a patient with DRESS syndrome during liver transplantation."

Case report • Clinical • Anesthesia • Eosinophilia • Gout • Hepatology • Immunology • Inflammation • Inflammatory Arthritis • Liver Failure • Rheumatology • Transplantation

Management of Allopurinol Induced Toxic Epidermal Necrolysis in Anesthesia Practice at an Academic Medical Center (ASA 2025) - "This included trialing manual ventilation before transitioning to HFPV. Additional perioperative anesthetic considerations included airway management, anesthetic drug dosing, and fluid and nutrition management."

Anesthesia • Diabetes • Gout • Inflammatory Arthritis • Metabolic Disorders • Renal Disease • Respiratory Diseases • Rheumatology • Steven-Johnson Syndrome • Thermal Injury

Mazdutide inhibits ASK1 phosphorylation and SLC7A11-GPX4 ferroptosis axis to improve rat uric acid nephropathy (EASD 2025) - "Eighty male SD rats were randomly divided into eight groups (n=10): blank control (CON), high-fat diet control (HFD), uric acid nephropathy (UN), Mazdutide low/medium/high-dose groups (0.025/0.05/0.075 mg·kg⁻¹), semaglutide group (GLP-1RA, mg·kg⁻¹), and allopurinol group (ALL, 25 mg·kg⁻¹). 1. Subcutaneous injection of Mazdutide every 3 days can improve uric acid nephropathy in SD rats.2. Administration of Mazdutide to HK-2 cells can improve cell viability reduced by uric acid administration and reduce cell apoptosis.3."

Late-breaking abstract • Preclinical • Metabolic Disorders • ACSL4 • FTL • GPX4 • SLC7A11 • TGFB1

Gout in the Corpus Hippocraticum (PubMed, G Ital Nefrol) - "Its therapy has been based on colchicine since Severus Iatrosophista, Theodosius the Philosopher, and Jacobus Psychrestos, introducing Colchicum as an innovative treatment for podagra in the early Byzantine period. A breakthrough in treatment was the introduction of allopurinol in 1966...In Affections, "Gout is a disease that induces burning pains in the joints; it comes to paroxysms, now in one limb, now in the other, where it causes ailments of variable severity". In Prorrhetics, it is described as a disease not amenable to cure in the elderly patients with tophi - a goal achievable in the young patient willing to adhere strictly to the therapy suggested by the physician."

Journal • Gout • Immunology • Inflammatory Arthritis • Musculoskeletal Pain • Pain • Rheumatology

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

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

Azithromycin-Induced Stevens-Johnson Syndrome in a Patient With SARS-CoV-2 and End-Stage Renal Disease. (PubMed, Cureus) - "Numerous medications have been associated with SJS, with abacavir, allopurinol, aromatic antiepileptic drugs, minocycline, proton pump inhibitors, and sulfasalazine being the most common. The clinical presentation of SJS usually includes atypical targets or purpuric macules, along with oral mucosal involvement. Herein, we present a case of SJS with primary oral mucosal involvement in a patient with end-stage renal disease (ESRD) due to polycystic kidney disease, recent SARS-CoV-2 infection, and azithromycin exposure."

Journal • Chronic Kidney Disease • Genetic Disorders • Infectious Disease • Nephrology • Novel Coronavirus Disease • Polycystic Kidney Disease • Renal Disease • Respiratory Diseases • Steven-Johnson Syndrome

Development and validation of a prognostic model for predicting the risk of allopurinol-induced severe cutaneous adverse reactions: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data. (PubMed, Lancet Rheumatol) - "We developed and validated a prognostic model for the 100-day risk of an allopurinol-induced severe cutaneous adverse reaction with good predictive performance and clinical utility. This model could be used to inform the choice of urate-lowering drugs."

Journal • Retrospective data • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Coronary Artery Disease • Gout • Heart Failure • Inflammatory Arthritis • Nephrology • Renal Disease • Rheumatology

Modelling allopurinol-induced severe adverse cutaneous reactions. (PubMed, Lancet Rheumatol) - No abstract available

Journal

Unifying Vascular Injury and Neurodegeneration: A Mechanistic Continuum in Cerebral Small Vessel Disease and Dementia. (PubMed, Eur J Neurosci) - "We synthesize molecular, imaging, and genetic evidence supporting this continuum, highlighting novel diagnostic and therapeutic targets such as peak skeletonized mean diffusivity, dynamic contrast-enhanced magnetic resonance imaging-based BBB leakage quantification, and emerging agents like cilostazol and allopurinol. We also critically appraise the limitations of current diagnostic frameworks and advocate for integrative, multimodal approaches to risk stratification. This model offers a unifying framework that bridges cerebrovascular and neurodegenerative domains, offering a foundation for precision medicine strategies aimed at dementia prevention and treatment."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • APOE

Commercial and non-commercial cyclodextrin derivatives as a novel therapy to improve gout's disease and hyperuricemia. (PubMed, Int J Pharm) - "In a murine model of MSU-induced knee inflammation, treatment with HPβ-CD and HBCD-Pol-either alone or in combination with standard anti-gout drugs (allopurinol, probenecid, colchicine, febuxostat) and bioactive compounds (resveratrol, oxyresveratrol)-significantly reduced inflammation, restored biochemical markers, and produced synergistic effects. HBCD-Pol demonstrated greater efficiency as a carrier, further enhancing drug activity. These findings indicate that CDs and HBCD-Pol, both based on authorized excipients, could provide a promising avenue for improving gout therapy and supporting the development of innovative treatment strategies."

Journal • Gout • Inflammation • Inflammatory Arthritis • Rheumatology

Drug-Induced Toxic Epidermal Necrolysis: A Case Report. (PubMed, Cureus) - "The medications most frequently associated with TEN include antibiotics such as sulfamethoxazole-trimethoprim (sulfonamides), penicillins, cephalosporins, and quinolones (e.g., ciprofloxacin); anticonvulsants such as phenytoin, carbamazepine, and lamotrigine; nonsteroidal anti-inflammatory drugs (NSAIDs), especially oxicam derivatives (e.g., piroxicam), and, less commonly, ibuprofen; allopurinol; nevirapine; and other agents such as paracetamol, celecoxib, tyrosine kinase inhibitors, and immunobiological therapies like infliximab...However, the use of immunomodulatory therapies, such as corticosteroids, cyclosporine, and biologics, remains a subject of ongoing debate, with inconsistent evidence regarding their efficacy...The prognosis in TEN is heavily influenced by factors such as advanced age, existing comorbidities, and the extent of skin involvement. Given the high fatality rates associated with TEN, especially in older adults, clinicians should maintain a high index..."

Journal • Geriatric Disorders • Immunology • Infectious Disease • Pain • Steven-Johnson Syndrome • HLA-B

Impact of Urate-Lowering Agents on Renal Outcomes in Chronic Kidney Disease: A Systematic Review. (PubMed, Cureus) - "Ten studies met the inclusion criteria, assessing allopurinol, febuxostat, verinurad, and topiroxostat. While febuxostat may slow CKD progression in select populations, evidence for allopurinol and combination therapies remains inconclusive. Heterogeneity in outcomes underscores the need for personalized treatment and further research to identify optimal candidates for ULA therapy."

Journal • Review • Chronic Kidney Disease • Nephrology • Renal Disease

Febuxostat-induced hepatocellular injury. (PubMed, BMJ Case Rep) - "Although it has a better safety profile compared to allopurinol, febuxostat has been associated with rare cases of drug-induced liver injury...After discontinuing febuxostat, the liver tests did not improve for 1 month until treatment with prednisone. This case adds to the existing literature on febuxostat-induced liver injury and highlights the variability in clinical and histological manifestations. It also emphasises the importance of monitoring liver tests in patients taking febuxostat."

Journal • Fatigue • Gout • Hepatology • Inflammatory Arthritis • Liver Failure • Rheumatology

The xanthine oxidase inhibitor allopurinol prevents thermal and mechanical hyperalgesia in a mouse model of peripheral mononeuropathy. (PubMed, Pharmacol Rep) - No abstract available

Journal • Preclinical • Pain

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

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