Effects of Uric Acid Production Inhibitor and Uricosuric Agents on Hyperuricemia of Gout by the Uric Acid Clearance Test

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To rationalize the use of uric acid production inhibitors and uricosuric agents in the treatment of hyperuricemia of patients with gout, effects of the drugs on uric acid metabolism of the patients have been investigated.<BR>Two hundreds and three patients with gout fed under low purine diet were treated for the first 2 weeks without any drugs affecting uric acid metabolism, and then the cases were treated with 300mg of allopurinol daily for the next 2 weeks, and were followed by administrations of 100mg of benzbromarone daily for further 2 weeks. At the end of each period of the treatment, uric acid clearance tests were carried out. Serum uric acid level (Sua), urinary uric acid excretion (Uua), uric acid clearance (Cua), creatinine clearance (Ccr) and ratio of Cua/Ccr (R) were calculated to estimate effects of allopurinol or benzbromarone on uric acid metabolism of gouty patients. Administration of allopurinol or benzbromarone resulted in significant reduction of Sua. The administration of allopurinol resulted in reduction of Sua associated with reduction of Uua but the administration of benzbromarone resulted in reduction of Sua associated with increase of Cua. After the administration of allopurinol to gouty patients with overproduction, rates of reduction of Uua as well as those of Cua were significantly higher than those to the patients with underexcretion. On the contrary, rates of increase of Cua after administration of benzbromarone were significantly lower in gouty patients with overproduction than in those with underexcretion. Administration of the uricosuric agent to patients with underexcretion produced better improvement of the Cua in rate than the administration to patients with overproduction.<BR>Administration of uric acid production inhibitors to patients with overproduction resulted in improvement of the uric acid metabolism in terms of production and excretion, but administration of the uric acid production inhibitor to patients with underexcretion revealed that abnormalities in production or excretion was not completely improved. Same were cases of administration of the uricosuric agent to patients with underexcretion.<BR>The findings indicate that administration of uric acid production inhibitor to gouty patients with overproduction as well as that of uricosuric agents to patients with underexcretion were more reasonable than administration of the uric acid production inhibiors to patients with overproduction or uricosuric agent to the patients with overproduction in view point of improvements of abnormalities in uric acid metabolism of the patients.

Effects of Uric Acid Production Inhibitor and Uricosuric Agents on Hyperuricemia of Gout by the Uric Acid Clearance Test

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