Tuesday, 07 Apr 2020

You are here

Allopurinol Reduces Cardiovascular Outcomes in Diabetes

A Canadian study has shown that elderly diabetics who take allopurinol have a significant reduction in cardiovascular outcomes.  

Hyperuricemia has been shown to be a biomarker for cardiovascular outcomes in multiple disorders. These investigators studied the effect of allopurinol and mortality on CV outcomes in a population-based retrospective cohort study from Ontario, Canada.

The primary CV outcome was a composite that included: all-cause mortality, non-fatal cardiovascular event (myocardial infarction, revascularization procedure, or stroke) or congestive heart failure (CHF). 

After a follow-up of 4.65 years, the primary CV outcome was seen in 16,266/23,103 males and 10,571/15,313 females.

Allopurinol use was associated with a significant reduction in the primary outcome by nearly 20% [adjusted hazard ratios 0.77 (95% confidence interval 0.75-0.80) and 0.81 (0.78-0.84) for male and females, respectively]. The cumulative allopurinol dose did not alter these outcomes.

Allopurinol was also associated with reduced risk of pneumonia in males [aHR 0.88 (0.83, 0.93)].

Allopurinol also decreases mortality and cardiovascular outcomes in older diabetics.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Interleukin-37 Targeting in Gout

The Annals of Rheumatic Disease reports that interleukin- 27 (IL-37) may play an important role in the pathogenesis of gout, paving the way for future therapy with recombinant IL-37 in gouty arthritis.

Activation of the inflammasome by monosodium urate crystals is thought to be paramount to the innate immune response that drives IL-1-mediated joint inflammation in gout.

Hyperuricemia Predisposes to Coronary Artery Disease in Men

There are numerous associations between hyperuricemia and cardiovascular disease (CVD). An analysis of the Swedish SCAPIS Pilot study shows that higher levels of serum urate (SU) are associated with an increase in coronary artery calcification score in men but not in women. SU is not associated with common carotid intima-media thickness and carotid plaque scores in either men or women.

Hypersensitivity Reactions and Gout Tx: Watch the Dose

Both allopurinol and febuxostat (Uloric) were associated with an increased risk of hypersensitivity reactions among new users of these urate-lowering therapies, a large U.S. study found.

Diabetics using SGLT2 Inhibitors have a lower Gout Risk

Researchers from the Brigham and Women's Hospital have reported that adults with type 2 diabetes who were treated with SGLT2 inhibitors had a lower risk of gout compared to GLP1 agonist, suggesting that sodium–glucose cotransporter-2 inhibitors may reduce the risk for gout with type 2 diabetes mellitus (T2DM).

A Role for SGLT2 Inhibition in Gout?

The antidiabetic medication canagliflozin (Invokana) lowered serum urate and reduced the risk of gout flare in a post-hoc analysis of data from two large clinical trials.