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A SHORT TRIAL ASSESSMENT OF URICOSURIC THERAPY IN GOUT
Author(s) -
PALMER D. G.,
HIGHTON T. C.
Publication year - 1968
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1968.17.3.242
Subject(s) - uricosuric , gout , probenecid , uric acid , renal function , allopurinol , medicine , sulfinpyrazone , urology , creatinine , endocrinology , pharmacology , hyperuricemia , platelet
Summary A study has been made of the short‐term effects of two uricosuric drugs (sulphinpyrazone and probenecid) in 12 gouty patients. The changes induced by these drugs on serum uric acid levels, 24‐hour urate excretion rates and urate clearance values have been related to glomerular function. Since allopurinol is now available for the therapy of gout, and as uricosuric agents may fail to resolve tophaceous deposits, it is held that long‐term uricosuric therapy should not be undertaken unless the efficacy of the chosen drug has been established. Therapeutic criteria have been proposed as a result of this trial. The magnitude of the urate diuresis induced by these drugs was found in general to be dependent on glomerular function; but even in the presence of a normal glomerular filtration rate a particular uricosuric drug could be ineffective. A glomerular filtration rate of less than 80 ml. per minute was associated with a relative failure of the drugs under trial, and it is considered that this level of renal impairment is an indication for the use of allopurinol. In the type of assessment described it is important that both the fall in the serum uric acid level and the rise in urate excretion should be estimated, for these changes do not under all circumstances bear a constant inverse relationship to one another.