The initiation of allopurinol was not associated with increased mortality, according to a study published in Annals of Internal Medicine. Yuqing Zhang, DSc, and colleagues used data from the Health Improvement Network (THIN) database on patients aged 40-89 with gout, concurrent moderate-to-severe CKD, and at least 1 year of continuous enrollment with a general practitioner. Mortality rates per 100 personyears were 4.9 for those who initiated allopurinol and 5.8 for those who did not (HR, 0.85; 95% CI, 0.77-0.93). When compared with patients who did not achieve the target serum urate level, those who did had a difference in 5- year mortality of -1.6% (95% CI, -3.6 to -0.5), with an HR of 0.87 (95% CI, 0.75-1.01). The difference in 5-year mortality was -1.4% when comparing those who escalated their dose of allopurinol with those who did not (95% CI, -3.7 to 0.4), with a corresponding HR of 0.88 (95% CI, 0.73-1.07). “In this populationbased data, neither allopurinol initiation, nor achieving target SU level with allopurinol, nor allopurinol dose escalation was associated with increased mortality in patients with gout and concurrent CKD,” wrote the study authors.
