allopurinol and Joint-Diseases

Topics: Allopurinol; Chondrocalcinosis; Colchicine; Diagnosis, Differential; Diet Therapy; Gout; Humans; Inosine Nucleotides; Joint Diseases; Metabolic Diseases; Orotic Acid; Purines; Urate Oxidase; Uric Acid; Uricosuric Agents

Chinese patients with arthralgia during treatment with an antituberculosis regimen containing pyrazinamide were allocated at random to 3 anti-arthralgia treatment series in a controlled double-blind study. One series (18 patients) received soluble aspirin 2.4 g daily, the second (23 patients) allopurinol 200 mg daily, and the third (19 patients) placebo only, for 8 weeks. The response was assessed both by independent assessors and by the patients themselves using a diary card. The serum uric acid concentration was measured before and during anti-arthralgia treatment. The joints most commonly affected were the shoulders, the knees and the fingers, and symptoms and signs were in general neither severe nor protracted. For most of the patients in all 3 series the joint symptoms and signs improved during the 8 weeks, but a higher proportion of patients in the aspirin and placebo series than in the allopurinol series experienced improvement, this being most rapid in the aspirin series. Only in the aspirin series was the mean serum uric acid concentration lower during treatment than before it, and this effect was related to the dose in mg per kg. It is concluded that the arthralgia was often self-limiting, that aspirin had a small beneficial effect, that allopurinol, in the dosage studied, may have had a slightly deleterious effect, but that it would be worth studying larger dosages of allopurinol because the dosage studied did not affect the serum uric acid concentration.

Topics: Adolescent; Adult; Aged; Allopurinol; Aspirin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Joint Diseases; Male; Middle Aged; Pain; Pyrazinamide; Random Allocation; Time Factors; Tuberculosis, Pulmonary; Uric Acid

Topics: Adult; Allopurinol; Anti-Bacterial Agents; Arthritis, Gouty; Biopsy; Bone Cysts; Gout Suppressants; Humans; Joint Diseases; Male; Metatarsophalangeal Joint; Panniculitis; Radiography; Skin Diseases; Uric Acid

Pyrazinamide (PZA) is increasingly used with isoniazid and rifampicin, in short-course antituberculous chemotherapy in service programme conditions. Complicating arthralgias occur due to hyperuricaemia induced by the inhibition of renal tubular secretion of uric acid by pyrazinoic acid, the main PZA metabolite. Allopurinol (Al), a hypouricaemic agent, provides no substantial clinical improvement. Pharmacokinetics of PZA and its metabolites were studied in six healthy volunteers, in a cross-over design, after a single oral dose of PZA alone and, in a second trial, after the same dose together with Al. Plasma and urinary concentrations were measured by high pressure liquid chromatography with a column of cation exchange resin. Analysis of the pharmacokinetic parameters showed that Al induced marked changes in levels of PZA metabolites and accumulation of pyrazinoic acid. Despite decreasing uric acid synthesis, allopurinol increased plasma concentrations of pyrazinoic acid, which is directly responsible for the inhibition of renal urate secretion. Other drugs, which do not involve xanthine oxidase inhibition, should be used in the treatment of this side effect of chemotherapy.

Topics: Adult; Allopurinol; Drug Interactions; Drug Therapy, Combination; Humans; Joint Diseases; Male; Pain; Pyrazinamide; Tuberculosis, Pulmonary; Uric Acid

Topics: Aged; Allopurinol; Captopril; Drug Synergism; Fever; Humans; Joint Diseases; Male; Muscular Diseases; Pain; Proline

Topics: Adult; Aged; Allopurinol; Colchicine; Gout; Humans; Joint Diseases; Middle Aged; Probenecid

Topics: Aged; Allopurinol; Female; Fingers; Gout; Humans; Joint Diseases; Joints; Long-Term Care; Male; Middle Aged; Radiography; Regression, Psychology; Skin Manifestations; Toes; Uric Acid

Topics: Adrenal Cortex Hormones; Adult; Allopurinol; Anti-Inflammatory Agents; Child; Chloroquine; Eye Diseases; Female; Gold; Humans; Indomethacin; Joint Diseases; Male; Phenylbutazone; Salicylates

Topics: Adult; Allopurinol; Gout; Guanine; Humans; Hypoxanthines; Joint Diseases; Kidney Calculi; Metabolism, Inborn Errors; Molecular Biology; Phosphotransferases; Purines; Uric Acid

Topics: Aged; Allopurinol; Gout; Humans; Joint Diseases; Osteitis Deformans; Rheumatic Diseases; Uricosuric Agents

Topics: Adolescent; Adult; Allopurinol; Child; Female; Glycogen Storage Disease; Glycogen Storage Disease Type I; Gout; Hepatomegaly; Humans; Hyperlipidemias; Joint Diseases; Lactates; Male; Middle Aged; Osteoporosis; Purines; Uric Acid; Uricosuric Agents

Topics: 17-Ketosteroids; Adult; Aged; Allopurinol; Arthritis; Dehydroepiandrosterone; Gout; Humans; Joint Diseases; Middle Aged; Uric Acid

Topics: Allopurinol; Colchicine; Crystallization; Diagnosis, Differential; Diet Therapy; Gout; Humans; Indomethacin; Joint Diseases; Kidney Diseases; Kidneys, Artificial; Phenylbutazone; Probenecid; Proteinuria; Purines; Radiography; Salicylates; Steroids; Sulfinpyrazone; Uric Acid

Topics: Achilles Tendon; Allopurinol; Cortisone; Diagnosis, Differential; Gout; Humans; Joint Diseases; Male; Middle Aged; Probenecid; Surgical Procedures, Operative; Tendinopathy; Uric Acid

Topics: Allopurinol; Gout; Humans; Joint Diseases; Kidney Calculi; Orotic Acid; Time Factors; Uric Acid; Urinary Calculi

Topics: Adult; Aged; Allopurinol; Anemia; Arthritis; Bicarbonates; Blood Sedimentation; Chronic Disease; Female; Gout; Humans; Joint Diseases; Male; Middle Aged; Phenylbutazone; Physical Exertion; Probenecid; Uric Acid