37507
document
Allopurinol use yields potentially beneficial effects on inflammatory indices in those with recent ischemic stroke : a randomized , double-blind , placebo-controlled trial . BACKGROUND AND PURPOSE Elevated serum uric acid level is associated with poor outcome and increased risk of recurrent events after stroke . The xanthine oxidase inhibitor allopurinol lowers uric acid but also attenuates expression of inflammatory adhesion molecules in murine models , reduces oxidative stress in the vasculature , and improves endothelial function . We sought to investigate whether allopurinol alters expression of inflammatory markers after acute ischemic stroke . METHODS We performed a randomized , double-blind , placebo-controlled trial to investigate the safety , tolerability , and effect of 6 weeks ' treatment with high- ( 300 mg once a day ) or low- ( 100 mg once a day ) dose allopurinol on levels of uric acid and circulating inflammatory markers after ischemic stroke . RESULTS We enrolled 50 patients with acute ischemic stroke ( 17 , 17 , and 16 in the high , low , and placebo groups , respectively ) . Mean ( +/-SD ) age was 70 ( +/-13 ) years . Groups had similar characteristics at baseline . There were no serious adverse events . Uric acid levels were significantly reduced at both 7 days and 6 weeks in the high-dose group ( by 0.14 mmol/L at 6 weeks , P=0.002 ) . Intercellular adhesion molecule-1 concentration ( ng/mL ) rose by 51.2 in the placebo group , rose slightly ( by 10.6 ) in the low-dose allopurinol group , but fell in the high-dose group ( by 2.6 ; difference between groups P=0.012 , Kruskal-Wallis test ) . CONCLUSIONS Allopurinol treatment is well tolerated and attenuates the rise in intercellular adhesion molecule-1 levels seen after stroke . Uric acid levels were lowered with high doses . These findings support further evaluation of allopurinol as a preventive measure after stroke .
37508
Intervention_Pharmacological
Allopurinol
37509
Intervention_Pharmacological
allopurinol
37510
Intervention_Pharmacological
allopurinol
37511
Intervention_Pharmacological
6 weeks ' treatment with high- ( 300 mg once a day ) or low- ( 100 mg once a day ) dose allopurinol
37512
Intervention_Control
placebo
37513
Intervention_Pharmacological
allopurinol
37514
Intervention_Pharmacological
Allopurinol
37515
Intervention_Pharmacological
allopurinol
37516
Outcome_Physical
Uric acid levels
37517
Outcome_Physical
Intercellular adhesion molecule-1 concentration
37518
Participant_Condition
those with recent ischemic stroke :