How to prevent allopurinol hypersensitivity reactions?
| Autor: | Murray L. Barclay, Lisa K. Stamp |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
Drug congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Gout media_common.quotation_subject Allopurinol Allopurinol hypersensitivity syndrome 030226 pharmacology & pharmacy Gout Suppressants Drug Hypersensitivity 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine medicine Humans Pharmacology (medical) media_common 030203 arthritis & rheumatology Dose-Response Relationship Drug business.industry Maintenance dose nutritional and metabolic diseases medicine.disease business Adverse drug reaction Kidney disease medicine.drug |
| Zdroj: | Rheumatology (Oxford, England). 57(suppl_1) |
| ISSN: | 1462-0332 |
| Popis: | Allopurinol hypersensitivity syndrome (AHS) is a severe and sometimes life-threatening adverse drug reaction. Although AHS is rare, the number of patients with gout requiring allopurinol is high, and there are sufficient overall cases of AHS to warrant consideration of preventive measures. Most cases occur within 8-9 weeks of commencing allopurinol, and good patient education at initiation may lead to rapid drug cessation at onset of symptoms. Pretreatment testing for HLA-B*5801 and avoidance of allopurinol when positive reduces the risk of AHS and is cost-effective in some ethnic groups. A low starting allopurinol dose may reduce AHS risk, but the relationship between maintenance dose and AHS is more controversial. Chronic kidney disease increases AHS risk, but slowly increasing the allopurinol dose in chronic kidney disease has not been associated with AHS. Alternative newer treatments are available for patients at risk of AHS, but similar adverse reactions can also occur with these. |
| Databáze: | OpenAIRE |
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