Abstract
The conventional treatment of those patients with gout in whom urate-lowering medication is considered desirable is to administer such drugs continuously for an indefinite period.
It has been shown that dissolution rates of urate crystals in normouricemic or hyperuricemic solutions in vitro are very fast compared with rates of crystal growth in supersaturated solutions. Our previous clinical studies have shown that after discontinuing treatment with allopurinol the serum uric acid level returns rapidly to pre-treatment values, but long periods may pass before the return of gouty arthritis. In the light of these observations it seems logical to assess the effect of intermittent control of hyperuricemia in the treatment of gout.
In a preliminary trial, six patients have been taking allopurinol for only two months in a year. The biochemical response has been as anticipated - normouricemia during treatment, with hyperuricemia resumed once the drug is stopped. However, to date the clinical response seems to have been comparable to that normally obtained with continuous therapy. The results are sufficiently encouraging to justify setting up a formal trial comparing continuous with intermittent treatment.
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Scott, J., Higgens, C. & Butler, R. INTERMITTENT CONTROL OF HYPERURICEMIA IN THE TREATMENT OF GOUT: 186. Pediatr Res 19, 774 (1985). https://doi.org/10.1203/00006450-198507000-00206
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DOI: https://doi.org/10.1203/00006450-198507000-00206