PMID- 17308859
OWN - NLM
STAT- MEDLINE
DCOM- 20071003
LR  - 20240302
IS  - 0770-3198 (Print)
IS  - 0770-3198 (Linking)
VI  - 26
IP  - 9
DP  - 2007 Sep
TI  - Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously 
      benzbromarone-treated gout patients.
PG  - 1459-65
AB  - In 2003, the uricosuric drug benzbromarone was withdrawn from the market. The 
      first alternative drug of choice was the xanthine oxidase inhibitor allopurinol. 
      The purpose was to (1) investigate the efficacy of allopurinol (standard dosage) 
      compared with previous treatment with benzbromarone; and (2) investigate the 
      combination therapy allopurinol-probenecid as an effective alternative treatment 
      compared with previous benzbromarone treatment. A prospective, open study was 
      carried out in a cohort of 51 gout patients who discontinued benzbromarone 
      therapy because of market withdrawal. Patients were given 200-300 mg allopurinol 
      (stage 1). When allopurinol failed to attain the target serum urate (sUr) levels 
      <or=0.30 mmol/l, probenecid 1,000 mg/day was added (stage 2). Treatment with 
      benzbromarone monotherapy (range: 100-200 mg/day; mean 138 mg/day) resulted in 
      92% of patients reaching target levels sUr <or= 0.30 mmol/l with a decrease of 
      61[11]% compared to baseline. In stage 1, 32 patients completed treatment with 
      allopurinol monotherapy (range 200-300 mg/day; mean 256 mg/day), which resulted 
      in 25% of patients attaining sUr target levels. Decrease in sUr levels was 
      36[11]%, which was significantly less compared to treatment with benzbromarone (p 
      < 0.001). In stage 2, 14 patients received allopurinol-probenecid combination 
      therapy, which resulted in 86% of patients attaining target sUr levels (after 
      failure on allopurinol monotherapy), which was comparable to previous treatment 
      with benzbromarone (p = 0.81). Decrease in sUr levels was 53[9]% (CI 95%: 
      48-58%), which was a non-significant difference compared to previous treatment 
      with benzbromarone (p = 0.23). Benzbromarone is a very effective 
      antihyperuricemic drug with 91% success in attainment of target sUr levels 
      <or=0.30 mmol/l. Allopurinol 200-300 mg/day was shown to be a less potent 
      alternative for most selected patients to attain target sUr levels (13% success). 
      In patients failing on allopurinol monotherapy, the addition of probenecid proves 
      to be an effective treatment strategy for attaining sUr target levels (86% 
      success).
FAU - Reinders, Mattheus K
AU  - Reinders MK
AD  - Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, 
      Henri Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands. m.reinders@znb.nl
FAU - van Roon, Eric N
AU  - van Roon EN
FAU - Houtman, Pieternella M
AU  - Houtman PM
FAU - Brouwers, Jacobus R B J
AU  - Brouwers JR
FAU - Jansen, Tim L Th A
AU  - Jansen TL
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20070217
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Uricosuric Agents)
RN  - 268B43MJ25 (Uric Acid)
RN  - 4POG0RL69O (Benzbromarone)
RN  - 63CZ7GJN5I (Allopurinol)
RN  - PO572Z7917 (Probenecid)
SB  - IM
MH  - Allopurinol/adverse effects/*therapeutic use
MH  - Benzbromarone/therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Female
MH  - Gout/*drug therapy
MH  - Humans
MH  - Hyperuricemia/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Probenecid/*therapeutic use
MH  - Uric Acid/*blood/urine
MH  - Uricosuric Agents/adverse effects/*therapeutic use
EDAT- 2007/02/20 09:00
MHDA- 2007/10/04 09:00
CRDT- 2007/02/20 09:00
PHST- 2006/07/02 00:00 [received]
PHST- 2006/12/23 00:00 [accepted]
PHST- 2006/12/14 00:00 [revised]
PHST- 2007/02/20 09:00 [pubmed]
PHST- 2007/10/04 09:00 [medline]
PHST- 2007/02/20 09:00 [entrez]
AID - 10.1007/s10067-006-0528-3 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2007 Sep;26(9):1459-65. doi: 10.1007/s10067-006-0528-3. Epub 2007 
      Feb 17.