The Role of Allopurinol and Angiotensin Receptor Blockers in Serum Uric Acid Reduction in Gouty and Hypertensive Patients

Abstract

0bjective: To evaluate the effect of Allopurinol in combination with angiotensin receptor blockers on hyperuricemia in gouty and hypertensive patients. 

Study design: Randomized, open label, prospective, comparative trial.

Place and Duration of Study: This study was conducted in the Department of Pharmacology. &Therapeutics; BMSI/JPMC, Karachi from April 2010 to November 2010.

Materials and Methods: 80 hypertensive and hyperuricemic patients were enrolled from OPD and medical wards and were divided into two groups. group DR-1(40 Patients) were given allopurinol 300mg plus candisartan 8mg daily and group DR-2 (40 patients) were given allopurinol 200mg Plus Losartan 50mg, daily four 4 months. 6 patients were unable to continue the follow-up 3 patients in each group.

Results: DR-1combination therapy decreased serum uric acid level from 8.92 ± 0.19mg/dl at day 0 to 5.33 ± 0.11mg/dl at day120. DR-2 group also showed a significant reduction in serum uric acid level from 9.14. ± 0.19mg/dl at day 0 to 4.74 ± 0.09mg/dl at day 120 (p < 0.001).  when effects were compared in both treatment groups, the effect of group 2 regimens on serum uric acid level was more marked due to Losartan combination which also have uricosuric effects than in  group 1 regimen, with average percentage decrease in serum uric acid -40.35% in group DR-1 and -48.24% in group DR-2.

Conclusion: The allopurinol 200mg and Losartan 50mg is more effective than allopurinol 300mg+ candesartan 8mg, to decrease serum uric acid level and group DR-2 drugs combination useful in those hyperuricemic patients who cannot tolerate high doses of uric acid lowering drugs.