Allopurinol and cardiovascular outcomes in patients with ischaemic heart disease: the ALL-HEART RCT and economic evaluation
Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol. To determine whether allopurinol improves major card...
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| Vydáno v: | Health technology assessment (Winchester, England) Ročník 28; číslo 18; s. 1 - 55 |
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01.03.2024
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| ISSN: | 2046-4924, 1366-5278, 2046-4924 |
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| Abstract | Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol.
To determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease.
Prospective, randomised, open-label, blinded endpoint multicentre clinical trial.
Four hundred and twenty-four UK primary care practices.
Aged 60 years and over with ischaemic heart disease but no gout.
Participants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care.
The primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis.
From 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm (
= 2979) or the usual care arm (
= 2958). A total of 5721 randomised participants (2853 allopurinol; 2868 usual care) were included in the modified intention-to-treat analysis population (mean age 72.0 years; 75.5% male). There was no difference between the allopurinol and usual care arms in the primary endpoint, 314 (11.0%) participants in the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04 (95% confidence interval 0.89 to 1.21);
= 0.65. Two hundred and eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%) participants in the usual care arm died, hazard ratio 1.02 (95% confidence interval 0.87 to 1.20);
= 0.77. The pre-specified health economic analysis plan was to perform a 'within trial' cost-utility analysis if there was no statistically significant difference in the primary endpoint, so NHS costs and quality-adjusted life-years were estimated over a 5-year period. The difference in costs between treatment arms was +£115 higher for allopurinol (95% confidence interval £17 to £210) with no difference in quality-adjusted life-years (95% confidence interval -0.061 to +0.060). We conclude that there is no evidence that allopurinol used in line with the study protocol is cost-effective.
The results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis.
The ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout.
The effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies.
This trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426).
This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in
; Vol. 28, No. 18. See the NIHR Funding and Awards website for further award information. |
|---|---|
| AbstractList | Abstract Background Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol. Objective To determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease. Design Prospective, randomised, open-label, blinded endpoint multicentre clinical trial. Setting Four hundred and twenty-four UK primary care practices. Participants Aged 60 years and over with ischaemic heart disease but no gout. Interventions Participants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care. Main outcome measures The primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis. Results From 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm (n = 2979) or the usual care arm (n = 2958). A total of 5721 randomised participants (2853 allopurinol; 2868 usual care) were included in the modified intention-to-treat analysis population (mean age 72.0 years; 75.5% male). There was no difference between the allopurinol and usual care arms in the primary endpoint, 314 (11.0%) participants in the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04 (95% confidence interval 0.89 to 1.21); p = 0.65. Two hundred and eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%) participants in the usual care arm died, hazard ratio 1.02 (95% confidence interval 0.87 to 1.20); p = 0.77. The pre-specified health economic analysis plan was to perform a ‘within trial’ cost-utility analysis if there was no statistically significant difference in the primary endpoint, so NHS costs and quality-adjusted life-years were estimated over a 5-year period. The difference in costs between treatment arms was +£115 higher for allopurinol (95% confidence interval £17 to £210) with no difference in quality-adjusted life-years (95% confidence interval −0.061 to +0.060). We conclude that there is no evidence that allopurinol used in line with the study protocol is cost-effective. Limitations The results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis. Conclusions The ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout. Future work The effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies. Trial registration This trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in Health Technology Assessment; Vol. 28, No. 18. See the NIHR Funding and Awards website for further award information. Plain language summary What was the question? The purpose of the ALL-HEART study was to determine whether giving allopurinol to people with ischaemic heart disease (also commonly known as coronary heart disease) would reduce their risk of having a heart attack, stroke or of dying from cardiovascular disease. Allopurinol is a medication usually given to patients with gout to prevent acute gout flares. It is not currently used to treat ischaemic heart disease. What did we do? We randomly allocated people aged over 60 years with ischaemic heart disease to take up to 600 mg of allopurinol daily (in addition to their usual care) or to continue with their usual care. We then monitored participants for several years and recorded any major health events such as heart attacks, strokes and deaths. We obtained most of the follow-up data from centrally held electronic hospital admissions and death records, making the study easier for participants and more cost-efficient. We asked participants in both groups to complete questionnaires to assess their quality of life during the study. We also collected data to determine whether there was any economic benefit to the NHS of using allopurinol in patients with ischaemic heart disease. What did we find? There was no difference in the risk of heart attacks, strokes or death from cardiovascular disease between the participants given allopurinol and those in the group continuing their usual care. We also found no difference in the risks of other cardiovascular events, deaths from any cause or quality-of-life measurements between the allopurinol and usual care groups. What does this mean? The results of the ALL-HEART study suggest that we should not recommend that allopurinol be given to people with ischaemic heart disease to prevent further cardiovascular events or deaths. Scientific summary Background Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid (SUA) and is widely used in patients with gout to prevent acute gout flares. Xanthine oxidase promotes inflammation and atherosclerosis via the production of reactive oxygen species and xanthine oxidase levels are raised in several conditions including coronary artery disease. The role of SUA in cardiovascular (CV) disease is controversial, with some studies associating higher SUA levels with worse CV outcomes, but more recent genome-wide association studies suggest no major role of uric acid levels in determining CV outcomes. Some observational studies have suggested that allopurinol therapy may improve CV outcomes, while others have not found an association. Small interventional studies have shown that allopurinol therapy improves some CV parameters, including endothelial function, left ventricular hypertrophy, blood pressure, carotid intimal media thickness and arterial stiffness. Allopurinol therapy was also found to improve outcomes after acute coronary syndrome (ACS) in one study and to improve chest pain in patients with chronic stable angina with documented coronary artery disease in another. However, results have not been consistent across different studies. Before the ALL-HEART study, no large, randomised trial of the effects of allopurinol therapy on CV outcomes in patients with ischaemic heart disease (IHD) had been performed. Objectives Primary Does allopurinol therapy added to usual care improve major CV outcomes in patients aged over 60 years with IHD but no gout? Secondary Does allopurinol therapy added to usual care improve all-cause mortality or other CV outcomes in patients with IHD? What is the cost-effectiveness of adding allopurinol up to 600 mg daily to usual care in patients with IHD? Does allopurinol therapy added to usual care improve quality of life assessed by general health survey [EuroQol-5 Dimensions, five-level version (EQ-5D-5L)] or coronary heart disease-specific questionnaire (Seattle angina questionnaire)? Methods Design and participants The ALL-HEART study was a prospective, randomised, open-label, blinded endpoint (PROBE) multicentre trial undertaken in patients with IHD. Participants were primarily recruited from 424 primary care practices via 18 regional centres in the UK, with a small number also referred into the study from secondary care centres. Eligible patients were aged 60 years or over, with a history of IHD [myocardial infarction (MI), angina or other evidence of IHD]. Exclusion criteria were: history of gout; known severe renal impairment [estimated glomerular filtration rate (eGFR) < 30 ml/minute/1.73 m2]; moderate-to-severe heart failure (HF) [New York Heart Association (NYHA) III–IV]; significant hepatic disease [e.g. alanine transaminase (ALT) > 3 × upper limit of normal, cirrhosis, ascites] (investigator opinion); currently taking part in another interventional clinical trial of an investigational medicinal product or medical device (or taken part in one within the last 3 months); previous allergy to allopurinol; previous serious adverse cutaneous (skin) reaction to any drug (e.g. Stevens–Johnson syndrome, toxic epidermal necrolysis, hospitalisation due to skin reaction to drug) (investigator opinion); already taking urate-lowering therapy (including allopurinol, febuxostat, sulfinpyrazone, benzbromarone, probenecid, rasburicase); taking azathioprine, mercaptopurine, ciclosporin or theophylline; malignancy (except non-metastatic, non-melanoma skin cancers, cervical in situ carcinoma, breast ductal carcinoma in situ, or stage 1 prostate carcinoma) within the last 5 years (investigator opinion). The exclusion criterion relating to renal impairment was originally ‘known renal impairment eGFR < 60 ml/minute/1.73 m2’ for patients recruited from the start of the trial (7 February 2014) until 4 Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol. To determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease. Prospective, randomised, open-label, blinded endpoint multicentre clinical trial. Four hundred and twenty-four UK primary care practices. Aged 60 years and over with ischaemic heart disease but no gout. Participants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care. The primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis. From 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm ( = 2979) or the usual care arm ( = 2958). A total of 5721 randomised participants (2853 allopurinol; 2868 usual care) were included in the modified intention-to-treat analysis population (mean age 72.0 years; 75.5% male). There was no difference between the allopurinol and usual care arms in the primary endpoint, 314 (11.0%) participants in the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04 (95% confidence interval 0.89 to 1.21); = 0.65. Two hundred and eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%) participants in the usual care arm died, hazard ratio 1.02 (95% confidence interval 0.87 to 1.20); = 0.77. The pre-specified health economic analysis plan was to perform a 'within trial' cost-utility analysis if there was no statistically significant difference in the primary endpoint, so NHS costs and quality-adjusted life-years were estimated over a 5-year period. The difference in costs between treatment arms was +£115 higher for allopurinol (95% confidence interval £17 to £210) with no difference in quality-adjusted life-years (95% confidence interval -0.061 to +0.060). We conclude that there is no evidence that allopurinol used in line with the study protocol is cost-effective. The results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis. The ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout. The effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies. This trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426). This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in ; Vol. 28, No. 18. See the NIHR Funding and Awards website for further award information. The purpose of the ALL-HEART study was to determine whether giving allopurinol to people with ischaemic heart disease (also commonly known as coronary heart disease) would reduce their risk of having a heart attack, stroke or of dying from cardiovascular disease. Allopurinol is a medication usually given to patients with gout to prevent acute gout flares. It is not currently used to treat ischaemic heart disease. We randomly allocated people aged over 60 years with ischaemic heart disease to take up to 600 mg of allopurinol daily (in addition to their usual care) or to continue with their usual care. We then monitored participants for several years and recorded any major health events such as heart attacks, strokes and deaths. We obtained most of the follow-up data from centrally held electronic hospital admissions and death records, making the study easier for participants and more cost-efficient. We asked participants in both groups to complete questionnaires to assess their quality of life during the study. We also collected data to determine whether there was any economic benefit to the NHS of using allopurinol in patients with ischaemic heart disease. There was no difference in the risk of heart attacks, strokes or death from cardiovascular disease between the participants given allopurinol and those in the group continuing their usual care. We also found no difference in the risks of other cardiovascular events, deaths from any cause or quality-of-life measurements between the allopurinol and usual care groups. The results of the ALL-HEART study suggest that we should not recommend that allopurinol be given to people with ischaemic heart disease to prevent further cardiovascular events or deaths. Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol.BackgroundAllopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol.To determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease.ObjectiveTo determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease.Prospective, randomised, open-label, blinded endpoint multicentre clinical trial.DesignProspective, randomised, open-label, blinded endpoint multicentre clinical trial.Four hundred and twenty-four UK primary care practices.SettingFour hundred and twenty-four UK primary care practices.Aged 60 years and over with ischaemic heart disease but no gout.ParticipantsAged 60 years and over with ischaemic heart disease but no gout.Participants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care.InterventionsParticipants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care.The primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis.Main outcome measuresThe primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis.From 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm (n = 2979) or the usual care arm (n = 2958). A total of 5721 randomised participants (2853 allopurinol; 2868 usual care) were included in the modified intention-to-treat analysis population (mean age 72.0 years; 75.5% male). There was no difference between the allopurinol and usual care arms in the primary endpoint, 314 (11.0%) participants in the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04 (95% confidence interval 0.89 to 1.21); p = 0.65. Two hundred and eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%) participants in the usual care arm died, hazard ratio 1.02 (95% confidence interval 0.87 to 1.20); p = 0.77. The pre-specified health economic analysis plan was to perform a 'within trial' cost-utility analysis if there was no statistically significant difference in the primary endpoint, so NHS costs and quality-adjusted life-years were estimated over a 5-year period. The difference in costs between treatment arms was +£115 higher for allopurinol (95% confidence interval £17 to £210) with no difference in quality-adjusted life-years (95% confidence interval -0.061 to +0.060). We conclude that there is no evidence that allopurinol used in line with the study protocol is cost-effective.ResultsFrom 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm (n = 2979) or the usual care arm (n = 2958). A total of 5721 randomised participants (2853 allopurinol; 2868 usual care) were included in the modified intention-to-treat analysis population (mean age 72.0 years; 75.5% male). There was no difference between the allopurinol and usual care arms in the primary endpoint, 314 (11.0%) participants in the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04 (95% confidence interval 0.89 to 1.21); p = 0.65. Two hundred and eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%) participants in the usual care arm died, hazard ratio 1.02 (95% confidence interval 0.87 to 1.20); p = 0.77. The pre-specified health economic analysis plan was to perform a 'within trial' cost-utility analysis if there was no statistically significant difference in the primary endpoint, so NHS costs and quality-adjusted life-years were estimated over a 5-year period. The difference in costs between treatment arms was +£115 higher for allopurinol (95% confidence interval £17 to £210) with no difference in quality-adjusted life-years (95% confidence interval -0.061 to +0.060). We conclude that there is no evidence that allopurinol used in line with the study protocol is cost-effective.The results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis.LimitationsThe results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis.The ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout.ConclusionsThe ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout.The effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies.Future workThe effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies.This trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426).Trial registrationThis trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426).This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in Health Technology Assessment; Vol. 28, No. 18. See the NIHR Funding and Awards website for further award information.FundingThis award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in Health Technology Assessment; Vol. 28, No. 18. See the NIHR Funding and Awards website for further award information. |
| Author | Pigazzani, Filippo MacDonald, Thomas M Rogers, Amy Avery, Anthony J Barr, Rebecca J Rooke, Evelien D Townend, Jonathan N Hawkey, Christopher J Greenlaw, Nicola Begg, Alan G Walker, Andrew Ritchie, Lewis D Taggar, Jaspal S Mackenzie, Isla S Dumbleton, Jennifer S Ford, Ian Duce, Suzanne L Struthers, Allan D Wei, Li |
| Author_xml | – sequence: 1 givenname: Isla S orcidid: 0000-0002-3680-7127 surname: Mackenzie fullname: Mackenzie, Isla S organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 2 givenname: Christopher J orcidid: 0000-0002-6031-1017 surname: Hawkey fullname: Hawkey, Christopher J organization: Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK – sequence: 3 givenname: Ian orcidid: 0000-0001-5927-1823 surname: Ford fullname: Ford, Ian organization: The Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK – sequence: 4 givenname: Nicola orcidid: 0000-0003-3847-1126 surname: Greenlaw fullname: Greenlaw, Nicola organization: The Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK – sequence: 5 givenname: Filippo orcidid: 0000-0002-8726-306X surname: Pigazzani fullname: Pigazzani, Filippo organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 6 givenname: Amy orcidid: 0000-0001-5207-7032 surname: Rogers fullname: Rogers, Amy organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 7 givenname: Allan D orcidid: 0000-0002-2926-2528 surname: Struthers fullname: Struthers, Allan D organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 8 givenname: Alan G orcidid: 0000-0002-9712-9227 surname: Begg fullname: Begg, Alan G organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 9 givenname: Li orcidid: 0000-0001-8840-7267 surname: Wei fullname: Wei, Li organization: School of Pharmacy, University College London, London, UK – sequence: 10 givenname: Anthony J orcidid: 0000-0001-7591-4438 surname: Avery fullname: Avery, Anthony J organization: Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK – sequence: 11 givenname: Jaspal S orcidid: 0000-0002-5031-0977 surname: Taggar fullname: Taggar, Jaspal S organization: Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK – sequence: 12 givenname: Andrew orcidid: 0000-0002-5372-856X surname: Walker fullname: Walker, Andrew organization: Salus Alba, Glasgow, UK – sequence: 13 givenname: Suzanne L orcidid: 0000-0001-6539-1311 surname: Duce fullname: Duce, Suzanne L organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 14 givenname: Rebecca J orcidid: 0000-0003-4820-4240 surname: Barr fullname: Barr, Rebecca J organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 15 givenname: Jennifer S orcidid: 0000-0001-9099-5555 surname: Dumbleton fullname: Dumbleton, Jennifer S organization: Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK – sequence: 16 givenname: Evelien D orcidid: 0000-0002-9174-777X surname: Rooke fullname: Rooke, Evelien D organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK – sequence: 17 givenname: Jonathan N orcidid: 0000-0002-5881-5806 surname: Townend fullname: Townend, Jonathan N organization: Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK – sequence: 18 givenname: Lewis D orcidid: 0000-0002-9380-7641 surname: Ritchie fullname: Ritchie, Lewis D organization: Academic Primary Care, University of Aberdeen, Aberdeen, UK – sequence: 19 givenname: Thomas M orcidid: 0000-0001-5189-6669 surname: MacDonald fullname: MacDonald, Thomas M organization: MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38551218$$D View this record in MEDLINE/PubMed |
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| References | Luengo-Fernandez (key2024032917123800_ref39-bib39) 2012; 43 Rajendra (key2024032917123800_ref31-bib31) 2011; 58 Tanaka (key2024032917123800_ref51-bib51) 2020; 17 Butler (key2024032917123800_ref14-bib14) 2000; 35 Kao (key2024032917123800_ref22-bib22) 2011; 22 Coyle (key2024032917123800_ref45-bib45) 2021; 88 Huang (key2024032917123800_ref28-bib28) 2017; 58 Gingles (key2024032917123800_ref23-bib23) 2019; 37 Public Health Scotland (key2024032917123800_ref42-bib42) Szwejkowski (key2024032917123800_ref21-bib21) 2013; 62 EQ-5D-5L (key2024032917123800_ref33-bib33) NIHR INCLUDE guidance (key2024032917123800_ref54-bib54) MacIsaac (key2024032917123800_ref52-bib52) 2016; 67 NIHR INCLUDE ethnicity guidance (key2024032917123800_ref53-bib53) Spertus (key2024032917123800_ref34-bib34) 1995; 25 Mackenzie (key2024032917123800_ref1-bib1) 2022; 400 Public Health Scotland (key2024032917123800_ref38-bib38) McEwan (key2024032917123800_ref41-bib41) 2020; 22 NIHR Remote Trial Delivery (key2024032917123800_ref48-bib48) Lim (key2024032917123800_ref26-bib26) 2018; 36 Rogers (key2024032917123800_ref46-bib46) 2021; 88 Morgan (key2024032917123800_ref19-bib19) 2018; 103 Spiekermann (key2024032917123800_ref3-bib3) 2003; 107 White (key2024032917123800_ref43-bib43) 2018; 378 Efstathiadou (key2024032917123800_ref6-bib6) 2019; 8 Doehner (key2024032917123800_ref12-bib12) 2002; 105 George (key2024032917123800_ref11-bib11) 2006; 114 Gaffo (key2024032917123800_ref17-bib17) 2021; 73 Palmer (key2024032917123800_ref40-bib40) 2002 Taggart (key2024032917123800_ref30-bib30) 1994; 71 Rekhraj (key2024032917123800_ref16-bib16) 2013; 61 Higgins (key2024032917123800_ref20-bib20) 2014; 100 Noman (key2024032917123800_ref27-bib27) 2010; 375 Personal Social Services Research Unit (PSSRU) (key2024032917123800_ref36-bib36) 2021 Chang (key2024032917123800_ref5-bib5) 2018; 8 Singh (key2024032917123800_ref7-bib7) 2019; 21 Farquharson (key2024032917123800_ref13-bib13) 2002; 106 Feig (key2024032917123800_ref18-bib18) 2008; 300 Mafham (key2024032917123800_ref44-bib44) 2020; 396 Pop-Busui (key2024032917123800_ref25-bib25) 2013; 56 Ju (key2024032917123800_ref9-bib9) 2019; 59 Mackenzie (key2024032917123800_ref32-bib32) 2016; 6 Johnson (key2024032917123800_ref29-bib29) 1991; 121 Kojima (key2024032917123800_ref50-bib50) 2019; 40 Rutherford (key2024032917123800_ref24-bib24) 2020; 6 Muiesan (key2024032917123800_ref4-bib4) 2016; 11 Suissa (key2024032917123800_ref10-bib10) 2021; 73 National Institute for Health and Care Excellence Single Technology Appraisal (key2024032917123800_ref37-bib37) Office of National Statistics (key2024032917123800_ref2-bib2) Lai (key2024032917123800_ref8-bib8) 2019; 67 Guthikonda (key2024032917123800_ref15-bib15) 2003; 107 Mackenzie (key2024032917123800_ref49-bib49) 2020; 396 Coyle (key2024032917123800_ref47-bib47) 2022; 23 |
| References_xml | – ident: key2024032917123800_ref33-bib33 – volume: 73 start-page: 1749 year: 2021 ident: key2024032917123800_ref10-bib10 article-title: Effectiveness of allopurinol in reducing mortality: time-related biases in observational studies publication-title: Arthritis Rheumatol doi: 10.1002/art.41710 – volume: 88 start-page: 1031 year: 2021 ident: key2024032917123800_ref45-bib45 article-title: Learning from Remote Decentralised Clinical Trial (RDCT) experiences: a qualitative analysis of interviews with trial personnel, patient representatives and other stakeholders publication-title: Br J Clin Pharmacol doi: 10.1111/bcp.15003 – volume-title: Empagliflozin for Treating Chronic Heart Failure with Reduced Ejection Fraction [ID3826] ident: key2024032917123800_ref37-bib37 – volume: 22 start-page: 2147 year: 2020 ident: key2024032917123800_ref41-bib41 article-title: Cost-effectiveness of dapagliflozin as a treatment for heart failure with reduced ejection fraction: a multinational health-economic analysis of DAPA-HF publication-title: Eur J Heart Fail doi: 10.1002/ejhf.1978 – volume: 23 start-page: 614 year: 2022 ident: key2024032917123800_ref47-bib47 article-title: A secondary qualitative analysis of stakeholder views about participant recruitment, retention, and adherence in decentralised clinical trials (DCTs) publication-title: Trials doi: 10.1186/s13063-022-06521-4 – volume: 105 start-page: 2619 year: 2002 ident: key2024032917123800_ref12-bib12 article-title: Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies publication-title: Circulation doi: 10.1161/01.CIR.0000017502.58595.ED – volume: 378 start-page: 1200 year: 2018 ident: key2024032917123800_ref43-bib43 article-title: Cardiovascular safety of Febuxostat or Allopurinol in patients with Gout publication-title: N Engl J Med doi: 10.1056/NEJMoa1710895 – volume-title: Data and Intelligence. Finance ident: key2024032917123800_ref38-bib38 – volume: 375 start-page: 2161 year: 2010 ident: key2024032917123800_ref27-bib27 article-title: High dose allopurinol prolongs exercise in chronic stable angina: a randomised placebo controlled trial publication-title: Lancet doi: 10.1016/S0140-6736(10)60391-1 – ident: key2024032917123800_ref53-bib53 – ident: key2024032917123800_ref2-bib2 – volume: 103 start-page: 941 year: 2018 ident: key2024032917123800_ref19-bib19 article-title: Effects of losartan and allopurinol on cardiorespiratory regulation in obstructive sleep apnoea publication-title: Exp Physiol doi: 10.1113/EP087006 – volume: 8 start-page: e012738 year: 2019 ident: key2024032917123800_ref6-bib6 article-title: Genetically determined uric acid and the risk of cardiovascular and neurovascular diseases: a mendelian randomization study of outcomes investigated in randomized trials publication-title: J Am Heart Assoc doi: 10.1161/JAHA.119.012738 – volume: 36 year: 2018 ident: key2024032917123800_ref26-bib26 article-title: The APEX trial: effects of allopurinol on exercise capacity, coronary and peripheral endothelial function, and natriuretic peptides in patients with cardiac syndrome X publication-title: Cardiovasc Ther doi: 10.1111/1755-5922.12311 – volume: 58 start-page: 360 year: 2017 ident: key2024032917123800_ref28-bib28 article-title: Clinical study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism publication-title: Hellenic J Cardiol doi: 10.1016/j.hjc.2017.01.004 – volume: 396 start-page: 1745 year: 2020 ident: key2024032917123800_ref49-bib49 article-title: FAST Study Group. Long-term cardiovascular safety of febuxostat compared with allopurinol in patients with gout (FAST): a multicentre, prospective, randomised, open-label, non-inferiority trial publication-title: Lancet doi: 10.1016/S0140-6736(20)32234-0 – volume: 40 start-page: 1778 year: 2019 ident: key2024032917123800_ref50-bib50 article-title: Febuxostat for Cerebral and CaRdiorenovascular Events PrEvEntion StuDy publication-title: Eur Heart J doi: 10.1093/eurheartj/ehz119 – volume: 400 start-page: 1195 year: 2022 ident: key2024032917123800_ref1-bib1 article-title: Allopurinol and cardiovascular outcomes in patients with ischaemic heart disease: a multicentre, prospective, randomised, open-label, blinded endpoint clinical trial the ALL-HEART study publication-title: Lancet doi: 10.1016/S0140-6736(22)01657-9 – volume: 114 start-page: 2508 year: 2006 ident: key2024032917123800_ref11-bib11 article-title: High-dose allopurinol improves endothelial function by profoundly reducing vascular oxidative stress and not by lowering uric acid publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.106.651117 – volume-title: Unit Costs of Health and Social Care year: 2021 ident: key2024032917123800_ref36-bib36 – volume: 62 start-page: 2284 year: 2013 ident: key2024032917123800_ref21-bib21 article-title: Allopurinol reduces left ventricular mass in patients with type 2 diabetes and left ventricular hypertrophy publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2013.07.074 – volume: 58 start-page: 820 year: 2011 ident: key2024032917123800_ref31-bib31 article-title: Mechanistic insights into the therapeutic use of high-dose allopurinol in angina pectoris publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2010.12.052 – volume: 61 start-page: 926 year: 2013 ident: key2024032917123800_ref16-bib16 article-title: High dose allopurinol reduces left ventricular mass in patients with ischaemic heart disease publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2012.09.066 – volume: 6 start-page: 146 year: 2020 ident: key2024032917123800_ref24-bib24 article-title: A randomized, controlled trial of the effect of allopurinol on left ventricular mass index in hemodialysis patients publication-title: Kidney Int Rep doi: 10.1016/j.ekir.2020.10.025 – volume: 300 start-page: 924 year: 2008 ident: key2024032917123800_ref18-bib18 article-title: Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial publication-title: JAMA doi: 10.1001/jama.300.8.924 – volume: 107 start-page: 416 year: 2003 ident: key2024032917123800_ref15-bib15 article-title: Xanthine oxidase inhibition reverses endothelial dysfunction in heavy smokers publication-title: Circulation doi: 10.1161/01.CIR.0000046448.26751.58 – ident: key2024032917123800_ref54-bib54 – volume: 8 start-page: 5234 year: 2018 ident: key2024032917123800_ref5-bib5 article-title: Association between serum uric acid and cardiovascular risk in nonhypertensive and nondiabetic individuals: the Taiwan I-Lan longitudinal aging study publication-title: Sci Rep doi: 10.1038/s41598-018-22997-0 – volume: 25 start-page: 333 year: 1995 ident: key2024032917123800_ref34-bib34 article-title: Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease publication-title: J Am Coll Cardiol doi: 10.1016/0735-1097(94)00397-9 – volume: 106 start-page: 221 year: 2002 ident: key2024032917123800_ref13-bib13 article-title: Allopurinol improves endothelial dysfunction in chronic heart failure publication-title: Circulation doi: 10.1161/01.CIR.0000022140.61460.1D – volume-title: Data and Intelligence. Finance ident: key2024032917123800_ref42-bib42 – volume: 88 start-page: 2843 year: 2021 ident: key2024032917123800_ref46-bib46 article-title: A systematic review of methods used to conduct decentralised clinical trials publication-title: Br J Clin Pharmacol doi: 10.1111/bcp.15205 – volume: 37 start-page: 2481 year: 2019 ident: key2024032917123800_ref23-bib23 article-title: Allopurinol treatment adversely impacts left ventricular mass regression in patients with well-controlled hypertension publication-title: J Hypertens doi: 10.1097/HJH.0000000000002189 – volume: 21 start-page: 1322 year: 2019 ident: key2024032917123800_ref7-bib7 article-title: Association between allopurinol and cardiovascular outcomes and all-cause mortality in diabetes: a retrospective, population-based cohort study publication-title: Diabetes Obes Metab doi: 10.1111/dom.13656 – volume: 71 start-page: 177 year: 1994 ident: key2024032917123800_ref30-bib30 article-title: Lack of cardioprotective efficacy of allopurinol in coronary artery surgery publication-title: Br Heart J doi: 10.1136/hrt.71.2.177 – volume: 6 start-page: e013774 year: 2016 ident: key2024032917123800_ref32-bib32 article-title: Multicentre, prospective, randomised, open-label, blinded endpoint trial of the efficacy of allopurinol therapy in improving cardiovascular outcomes in patients with ischaemic heart disease: protocol of the ALL-HEART study publication-title: BMJ Open doi: 10.1136/bmjopen-2016-013774 – volume-title: A Cost-Effectiveness Model Comparing Alternative Management Strategies for the Use of Glycoprotein IIb/IIIa Antagonists in Non-ST Elevation Acute Coronary Syndrome year: 2002 ident: key2024032917123800_ref40-bib40 – volume: 59 start-page: 2340 year: 2019 ident: key2024032917123800_ref9-bib9 article-title: Comparative cardiovascular risk in users versus non-users of xanthine oxidase inhibitors and Febuxostat versus Allopurinol users publication-title: Rheumatology doi: 10.1093/rheumatology/kez576 – volume: 107 start-page: 1383 year: 2003 ident: key2024032917123800_ref3-bib3 article-title: Electron spin resonance characterization of vascular xanthine and NAD(P)H oxidase activity in patients with coronary artery disease: relation to endothelium-dependent vasodilation publication-title: Circulation doi: 10.1161/01.CIR.0000056762.69302.46 – volume: 67 start-page: 48 year: 2019 ident: key2024032917123800_ref8-bib8 article-title: Case–control study examining the association between allopurinol use and ischemic cerebrovascular disease publication-title: J Investig Med doi: 10.1136/jim-2018-000774 – ident: key2024032917123800_ref48-bib48 – volume: 67 start-page: 535 year: 2016 ident: key2024032917123800_ref52-bib52 article-title: Allopurinol and cardiovascular outcomes in adults with hypertension publication-title: Hypertension doi: 10.1161/HYPERTENSIONAHA.115.06344 – volume: 35 start-page: 746 year: 2000 ident: key2024032917123800_ref14-bib14 article-title: Allopurinol normalises endothelial dysfunction in type 2 diabetics with mild hypertension publication-title: Hypertension doi: 10.1161/01.HYP.35.3.746 – volume: 73 start-page: 1514 year: 2021 ident: key2024032917123800_ref17-bib17 article-title: Effect of serum urate lowering with allopurinol on blood pressure in young adults: a randomized, controlled, crossover trial publication-title: Arthritis Rheumatol doi: 10.1002/art.41749 – volume: 56 start-page: 1835 year: 2013 ident: key2024032917123800_ref25-bib25 article-title: Effects of triple antioxidant therapy on measures of cardiovascular autonomic neuropathy and on myocardial blood flow in type 1 diabetes: a randomised controlled trial publication-title: Diabetologia doi: 10.1007/s00125-013-2942-9 – volume: 43 start-page: 3343 year: 2012 ident: key2024032917123800_ref39-bib39 article-title: A population-based study of hospital care costs during 5 years after transient ischemic attack and stroke publication-title: Stroke doi: 10.1161/STROKEAHA.112.667204 – volume: 22 start-page: 1382 year: 2011 ident: key2024032917123800_ref22-bib22 article-title: Allopurinol benefits left ventricular mass and endothelial dysfunction in chronic kidney disease publication-title: J Am Soc Nephrol doi: 10.1681/ASN.2010111185 – volume: 17 start-page: e1003095 year: 2020 ident: key2024032917123800_ref51-bib51 article-title: Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: a randomized, controlled trial publication-title: PLOS Med doi: 10.1371/journal.pmed.1003095 – volume: 100 start-page: 1085 year: 2014 ident: key2024032917123800_ref20-bib20 article-title: Allopurinol reduces brachial and central blood pressure, and carotid intima-media thickness progression after ischaemic stroke and transient ischaemic attack: a randomised controlled trial publication-title: Heart doi: 10.1136/heartjnl-2014-305683 – volume: 396 start-page: 381 year: 2020 ident: key2024032917123800_ref44-bib44 article-title: COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England publication-title: Lancet doi: 10.1016/S0140-6736(20)31356-8 – volume: 121 start-page: 20 year: 1991 ident: key2024032917123800_ref29-bib29 article-title: A randomized controlled trial of allopurinol in coronary bypass surgery publication-title: Am Heart J doi: 10.1016/0002-8703(91)90950-M – volume: 11 start-page: 54 year: 2016 ident: key2024032917123800_ref4-bib4 article-title: Uric acid and cardiovascular disease: an update publication-title: Eur Cardiol doi: 10.15420/ecr.2016:4:2 |
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| Snippet | Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small... The purpose of the ALL-HEART study was to determine whether giving allopurinol to people with ischaemic heart disease (also commonly known as coronary heart... Abstract Background Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout.... |
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| SubjectTerms | allopurinol cardiovascular system cause of death cost-benefit analysis gout humans multicentre studies myocardial infarction myocardial ischaemia prospective studies randomised controlled trials stroke united kingdom xanthine oxidase |
| Title | Allopurinol and cardiovascular outcomes in patients with ischaemic heart disease: the ALL-HEART RCT and economic evaluation |
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