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Allopurinol

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Pharmacogenomic Testing in Current Clinical Practice

Part of the book series: Molecular and Translational Medicine ((MOLEMED))

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Abstract

Allopurinol (ZYLOPRIM), chemically described as 1,5-dihydro-4H-pyrazolo (3,4-d)pyrimidin-4-one, is a xanthine oxidase inhibitor used to treat patients with gout, kidney stones, and hyperuricemia associated with cancer therapy.

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References

  1. Terkeltaub, R. A. (2003). Clinical practice. Gout. The New England Journal of medicine, 349, 1647–1655.

    Article  CAS  PubMed  Google Scholar 

  2. Zhang, W., Doherty, M., Bardin, T., Pascual, E., Barskova, V., Conaghan, P., et al. (2006). EULAR Standing Committee for International Clinical Studies Including Therapeutics. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Annals of the Rheumatic Diseases, 65, 1312–1324.

    Article  CAS  PubMed  Google Scholar 

  3. Wortmann, R. L. (2002). Gout and hyperuricemia. Current Opinion in Rheumatology, 14, 281–6.

    Article  PubMed  Google Scholar 

  4. Chohan, S., Becker, M. A. (2009). Update on emerging urate-lowering therapies. Current Opinion in Rheumatology, 21, 143–149.

    Article  CAS  PubMed  Google Scholar 

  5. Kramer, H. M., Curhan, G. (2002). The association between gout and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988–1994. American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation, 40, 37–42.

    Google Scholar 

  6. Lawrence, R. C., Felson, D. T., Helmick, C. G., Arnold, L. M., Choi, H., Deyo, R. A., et al. (2008). National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis and Rheumatism, 58, 26–35.

    Article  PubMed  Google Scholar 

  7. Terkeltaub, R. (2009). Novel therapies for treatment of gout and hyperuricemia. Arthritis Research & Therapy, 11, 236–246.

    Article  Google Scholar 

  8. Wallace, K. L., Riedel, A. A., Joseph-Ridge, N., Wortmann, R. (2004). Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population. The Journal of Rheumatology, 31, 1582–1587.

    PubMed  Google Scholar 

  9. Mikuls, T. R., Farrar, J. T., Bilker, W. B., Fernandes, S., Schumacher, H. R. Jr, Saag, K. G. (2005). Gout epidemiology: results from the UK General PracticeResearch Database, 1990–1999. Annals of the Rheumatic Diseases, 64, 267–272.

    Article  CAS  PubMed  Google Scholar 

  10. Roddy, E., Zhang, W., Doherty, M. (2007). The changing epidemiology of gout. Nature Clinical Practice. Rheumatology, 3, 443–449.

    Article  PubMed  Google Scholar 

  11. Campion, E. W., Glynn, R. J., DeLabry, L. O. (1987). Asymptomatic hyperuricemia. Risks and consequences in the normative aging study. The American Journal of Medicine, 82, 421–426.

    Article  CAS  PubMed  Google Scholar 

  12. Bieber, J. D., Terkeltaub, R. A. (2004). Gout: on the brink of novel therapeutic options for an ancient disease. Arthritis and Rheumatism, 50, 2400–2414.

    Article  PubMed  Google Scholar 

  13. Chao, J., Terkeltaub, R. (2009). A critical reappraisal of allopurinol dosing, safety, and efficacy for hyperuricemia in gout. Current Rheumatology Reports, 11, 135–140.

    Article  CAS  PubMed  Google Scholar 

  14. Romeijnders, A. C., Gorter, K. J. (2002). Summary of the Dutch College of General Practitioners’ “Gout” Standard. Nederlands Tijdschrift Voor Geneeskunde, 146, 309–313.

    CAS  PubMed  Google Scholar 

  15. Perez-Ruiz, F., Lioté, F. (2007). Lowering serum uric acid levels: what is the optimal target for improving clinical outcomes in gout? Arthritis and Rheumatism, 57, 1324–1328.

    Article  PubMed  Google Scholar 

  16. Pluim, H. J., van Deuren, M., Wetzels, J. F. (1998). The allopurinol hypersensitivity ­syndrome. The Netherlands Journal of Medicine, 52, 107–10.

    Article  CAS  PubMed  Google Scholar 

  17. Arellano, F., Sacristan, J. A. (1993). Allopurinol hypersensitivity syndrome: a review. The Annals of Pharmacotherapy, 27, 337–343.

    CAS  PubMed  Google Scholar 

  18. Lee, H. Y., Ariyasinghe, J. T. N., Thirumoorthy, T. (2008). Allopurinol hypersensitivity ­syndrome: a preventable severe cutaneous adverse reaction? Singapore Medical Journal, 49, 384–387.

    CAS  PubMed  Google Scholar 

  19. Hande, K. R., Noone, R. M., Stone, W. J. (1984). Severe allopurinol toxicity: description and guidelines for prevention in patients with renal insufficiency. The American Journal of Medicine, 76, 47–56.

    Article  CAS  PubMed  Google Scholar 

  20. Vazquez-Mellado, J., Morales, E. M., Pacheco-Tena, C., Burgos-Vargas, R. (2001). Relation between adverse events associated with allopurinol and renal function in patients with gout. Annals of the Rheumatic Diseases, 60, 981–983.

    Article  CAS  PubMed  Google Scholar 

  21. Aubock, J., Fritsch, P. (1985). Asymptomatic hyperuricaemia and allopurinol induced toxic epidermal necrolysis. British Medical Journal, 290, 1969–1970.

    Article  CAS  PubMed  Google Scholar 

  22. Roujeau, J. C. (1994). The spectrum of Stevens–Johnson syndrome and toxic epidermal necrolysis: a clinical classification. The Journal of Investigative Dermatology, 102, 28S–30S.

    Article  CAS  PubMed  Google Scholar 

  23. Halevy, S., Ghislain, P. D., Mockenhaupt, M., Fagot, J. P., Bouwes Bavinck, J. N., Sidoroff, A., et al. for the EuroSCAR Study Group. (2008). Allopurinol is the most common cause of Stevens–Johnson syndrome and toxic epidermal necrolysis in Europe and Israel. Journal of the American Academy of Dermatology, 58, 25–32.

    Article  PubMed  Google Scholar 

  24. Lin, M. S., Dai, Y. S., Pwu, R. F., Chen, Y. H., Chang, N. C. (2005). Risk estimates for drugs suspected of being associated with Stevens–Johnson syndrome and toxic epidermal necrolysis: a case-control study. Internal Medicine Journal, 35, 188–190.

    Article  PubMed  Google Scholar 

  25. Jantararoungtong, T., Tiamkao, S., Vannaprasath, S., Choonhakarn, C., Auvichayapat, N., Tassaneeyakul, W. (2009). Stevens–Johnson syndrome and toxic epidermal necrolysis in Srinagarind hospital: a retrospective study of causative drugs and clinical outcome. Thai Journal of Pharmacology, 31, 41–43.

    Google Scholar 

  26. Hung, S. I., Chung, W. H., Chen, Y. T. (2005). HLA-B genotyping to detect carbamazepine-induced Stevens–Johnson syndrome: implications for personalizing medicine. Personalazed Medicine, 2, 225–237.

    Article  CAS  Google Scholar 

  27. Roujeau, J. C. (2006). Immune mechanisms in drug allergy. Allergology International: Official Journal of the Japanese Society of Allergology, 55, 27–33.

    CAS  Google Scholar 

  28. Melsom, R. D. (1999). Familial hypersensitivity to allopurinol with subsequent desensitization. Rheumatology, 38, 1301.

    Article  CAS  PubMed  Google Scholar 

  29. Hung, S. I., Chung, W. H., Liou, L. B., Chu, C. C., Lin, M., Huang, H. P., et al. (2005). HLA*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proceedings of the National Academy of Sciences of the United States of America, 102, 4134–4139.

    Article  CAS  PubMed  Google Scholar 

  30. Lonjou, C., Borot, N., Sekula, P., Ledger, N., Thomas, L., Halevy, S., et al. 2008;RegiSCAR study group. A European study of HLA-B in Stevens–Johnson syndrome and toxic epidermal necrolysis related to five high-risk drugs. Pharmacogenetics and Genomics, 18, 99–107.

    Article  CAS  PubMed  Google Scholar 

  31. Dainichi, T., Uchi, H., Moroi, Y., Furue, M. 2007;Stevens–Johnson syndrome, drug- induced hypersensitivity syndrome and toxic epidermal necrolysis caused by allopurinol in patients with a common HLA allele: what causes the diversity? Dermatology, 215, 86–88.

    Article  PubMed  Google Scholar 

  32. Kaniwa, N., Saito, Y., Aihara, M., Matsunaga, K., Tohkin, M., Kurose, K., et al. JSAR research group (2008) HLA-B locus in Japanese patients with anti-epileptics and allopurinol-related Stevens–Johnson syndrome and toxic epidermal necrolysis. Pharmacogenomics, 9, 1617–1622.

    Article  CAS  PubMed  Google Scholar 

  33. Wichittra, T., Thawinee, J., Chen, P., Lin, P. Y., Somsak, T., Usanee, K., et al. (2009). Strong association between HLA-B*5801 and allopurinol-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in a Thai population. Pharmacogenetics and Genomics, 19, 704–709.

    Article  Google Scholar 

  34. Nolan, D., Gaudieri, S., Mallal, S. (2003). Pharmacogenetics: a practical role in predicting antiretroviral drug toxicity. Journal of HIV Therapy, 8, 36–41.

    CAS  PubMed  Google Scholar 

  35. Phillips, K. A., Veenstra, D., Van Bebber, S., Sakowski, J. (2003). An introduction to cost-effectivness and cost-benefit analysis of pharmacogenomics. Pharmacogenomics, 4, 231–239.

    Article  PubMed  Google Scholar 

  36. Pacher, P., Nivorozhkin, A., Szabo, C. (2006). Therapeutic effects of xanthine oxidase inhibitors: Renaissance half a century after the discovery of allopurinol. Pharmacological Reviews, 58, 87–114.

    Article  CAS  PubMed  Google Scholar 

  37. Suzuki, I., Yamauchi, T., Onuma, M., Nozaki, S. (2009). Allopurinol, an inhibitor of uric acid synthesis – CAN it be used for the treatment of metabolic syndrome and related disorders? Drugs of Today, 45, 363–368.

    Article  PubMed  Google Scholar 

  38. Suzuki, Y., Inagi, R., Aono, T., Yamanishi, K., Shiohara, T. (1998). Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome. Archives of Dermatology, 134, 1108–1112.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan

    Yuan-Tsong Chen

  2. Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA

    Yuan-Tsong Chen

Authors
  1. Pei Chen
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  2. Shuen-Iu Hung
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  3. Shih-Yang Chen
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  4. Yuan-Tsong Chen
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Corresponding author

Correspondence to Yuan-Tsong Chen .

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Editors and Affiliations

  1. San Francisco General Hospital, Clinical Chemistry Lab., University of California, San Francisco, 1001 Potrero Ave., San Francisco, 94110, California, USA

    Alan H. B. Wu

  2. Department of Pathology, Clinical Pharmacogenomics Program, University of Chicago, S. Maryland Ave. 5841, Chicago, 60637, Illinois, USA

    Kiang-Teck J. Yeo

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Chen, P., Hung, SI., Chen, SY., Chen, YT. (2011). Allopurinol. In: Wu, A., Yeo, KT. (eds) Pharmacogenomic Testing in Current Clinical Practice. Molecular and Translational Medicine. Humana Press. https://doi.org/10.1007/978-1-60761-283-4_13

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  • DOI: https://doi.org/10.1007/978-1-60761-283-4_13

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-282-7

  • Online ISBN: 978-1-60761-283-4

  • eBook Packages: MedicineMedicine (R0)

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