Gentle upping of allopurinol is safe and effective

It is safe to slowly escalate allopurinol levels beyond the creatinine clearance-based dose in patients with gout, two-year results from a New Zealand study have confirmed.

This follows a report on an unblinded 12-month clinical trial comparing remaining on a creatinine-clearance-based dose of the drug to gentle dose escalation to bring serum urate levels to 357mmol/L.

In a trial extension, the 93 participants in the control arm were placed on the dose escalation regime for a year, while the 90 already undergoing dose escalation continued to do so.