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Gout drug does not improve outcomes for heart disease patients

Published: 20 October 2022

Patients with coronary heart disease did not benefit from treatment with a drug used to treat gout, NIHR-funded research finds.

The ALL-HEART study, published in the Lancet journal, found the drug allopurinol failed to prevent adverse cardiovascular outcomes in patients with heart disease without gout.

Experts at the University of Dundee and NHS Tayside, led the study over nine years. They analysed results from 5,721 patients across the UK over a seven-year period.

Principal Investigator Professor Isla Mackenzie, said: “The ALL-HEART study has shown that allopurinol therapy does not improve major cardiovascular outcomes in patients with ischaemic heart disease.

“Allopurinol is already widely used in patients with gout to prevent acute flares, and many of these patients have co-existing ischaemic heart disease. The question of whether allopurinol might prevent cardiovascular events in people with heart disease, but no clinical gout, has been around for many years and we are pleased to have now definitively answered this question for patients and doctors in a robust study.”

Previous studies showed allopurinol displayed cardiovascular benefits for patients with angina or coronary artery disease. This included increased exercise time and reduced chest pain as results of taking the drug.

The study group consisted of over 60s with ischaemic heart disease (also referred to as coronary heart disease), but no history of gout. Half received a daily dose of allopurinol and the other received regular care.

Experts found there was no evidence of different health outcomes between patients in the two groups. This ruled out allopurinol as a beneficial form of medication for these patients. The findings also revealed no difference between the groups in the secondary study outcomes. This included cardiovascular death, hospitalisation for heart failure, and all cardiovascular hospitalisations.

Professor Mackenzie added: “Managing heart disease is incredibly important for patients and exploring potential treatments and therapies that could improve quality of life is an important topic of research.

“While this news will undoubtedly be disappointing for those living with ischaemic heart disease, ALL-HEART has at least been able to offer clarity on the effectiveness of allopurinol.

“It means that new avenues of research can now be explored in the quest to help those living with one of the most pressing health issues in our society.”

NIHR’s Health Technology Assessment (HTA) Programme funded the study.

Read more on the study’s project page.


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