Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four adult patients with unstable angina were treated with intravenous nitroglycerin in the coronary intensive care unit. All four patients experienced an acute gouty flare while receiving or within 12 hours of discontinuing intravenous nitroglycerin. Serum uric acid levels ranged from 400 to 550 mumol/L at the time of the attack. In one patient, serum uric acid levels were followed while he was receiving intravenous nitroglycerin and were noted to increase nearly 60 mumol/L. It was speculated that the alcohol content of intravenous nitroglycerin preparations may alter serum uric acid levels and thus precipitate acute gouty flares in patients who are at increased risk for gout.
 ...
PMID:Acute gouty arthritis and intravenous nitroglycerin. 314 83

Comprehensive safety evaluation of new drugs for noncardiac indications is needed in the area of cardiovascular (CV) outcomes, particularly in populations with high CV risk such as gout. Febuxostat is a potent nonpurine selective inhibitor of xanthine oxidase approved for the treatment of gout. Long-term CV safety of febuxostat is being established in a randomized, allopurinol-controlled clinical study in patients with gout who have increased CV risk using an analytical approach that provides 90% power to meet a noninferiority margin of 1.3 for the hazard ratio (HR) (febuxostat relative to allopurinol). The primary CV end point for this trial is a composite of CV death, nonfatal myocardial infarction, nonfatal stroke, and unstable angina requiring urgent coronary revascularization. Approximately 7,500 men and women with gout and CV disease are being recruited and will be followed up for up to 5 years postrandomization. The statistical plan for the trial uses a design that evaluates the HR of febuxostat to allopurinol based on the primary CV composite end point when there are a maximum of 624 CV events. Interim analyses will be conducted when approximately 25%, 50%, and 75% of events have occurred. At each analysis, if the upper 1-sided confidence limit of the HR is <1.3, the study will be stopped, and the noninferiority of febuxostat relative to allopurinol with regard to CV risk will be declared. The CARES trial will define the CV safety profile of febuxostat and allopurinol in gout patients at high risk for CV events.
 ...
PMID:Cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular comorbidities. 2279 77