Article Sidebar

Download
PDF
Statistic
Read Counter : 6 Download : 2

Downloads

Download data is not yet available.

Main Article Content

Abstract

Gout Arthritis is an inflammatory joint disease caused by the deposition of monosodium urate crystals in the joint areas, particularly in the extremities. In the therapeutic process, allopurinol is the first-line choice, especially in asymptomatic hyperuricemia, intercritical, and chronic phases. In Indonesia, there is no data discussing gout arthritis and the study pattern of allopurinol for gout arthritis patients, especially in Palembang, South Sumatra. This study aimed to evaluate the prescribing pattern of allopurinol in gout arthritis patients at Sekip Primary Health Center, Palembang. A retrospective descriptive drug utilization study was conducted using secondary data from medical records between July 1, 2021 and June 30, 2022. Total sampling was applied, and 101 eligible patients were included. The majority of patients were male (61.3%) and elderly (50.5%). The appropriateness of allopurinol use was assessed based on diagnosis, indication, dosage, frequency, duration, and potential drug interactions. Most prescriptions were appropriate in terms of diagnosis (96.1%) and indication (96.1%), with all patients receiving correct dosage and frequency (100%). The majority received once-daily dosing (53.5%) and treatment duration of less than two weeks (81.2%). Drug interactions were identified in a small proportion of cases. In conclusion, allopurinol prescribing patterns were generally appropriate; however, some cases lacked supporting laboratory evaluation prior to therapy initiation. Strengthening adherence to clinical guidelines is recommended.

Article Details

References

  1. Allopurinol Tablets USP 100 mg and 300 mg Tablets. Retrieved November 28, 2023, from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=60cdd69c-fd25-77de-e053-2a91aa0ad472&type=display
  2. Badan Penelitian dan Pengembangan Kesehatan Kementerian Republik Indonesia. Laporan Riset Kesehatan Dasar (Riskesdas) Provinsi Sumatera Selatan. Jakarta; 2018.
  3. Bai, L., Zhou, J.-B., Zhou, T., Newson, R. B., & Cardoso, M. A. (2021). Incident Gout and Weight Change Patterns: A Retrospective Cohort Study of US Adults. Arthritis Research & Therapy, 23(1), 69. https://doi.org/10.1186/s13075-021-02461-7
  4. Bechtold, M., Palmer, J., Valtos, J., Iasiello, C., & Sowers, J. (2006). Metabolic Syndrome in The Elderly. Current Diabetes Reports, 6(1), 64–71. https://doi.org/10.1007/s11892-006-0054-3
  5. Boston Collaborative Drug Surveilance Program. Excess of Ampicillin Rashes Associated with Allopurinol or Hyperuricemia. (1972). New England Journal of Medicine, 286(10), 505–507. https://doi.org/10.1056/NEJM197203092861002
  6. Dalbeth, N., Choi, H. K., Joosten, L. A. B., Khanna, P. P., Matsuo, H., Perez-Ruiz, F., & Stamp, L. K. (2019). Gout. Nature Reviews Disease Primers, 5(1), 69. https://doi.org/10.1038/s41572-019-0115-y
  7. Danve, A., & Neogi, T. (2020). Rising Global Burden of Gout: Time to Act. Arthritis & Rheumatology, 72(11), 1786–1788. https://doi.org/10.1002/art.41453
  8. El-Sheikh, A. a K., Van Den Heuvel, J. J. M. W., Koenderink, J. B., & Russel, F. G. M. (2008). Effect of Hypouricaemic and Hyperuricaemic Drugs on the Renal Urate Efflux Transporter, Multidrug Resistance Protein 4. British Journal of Pharmacology, 155(7), 1066–1075. https://doi.org/10.1038/bjp.2008.343
  9. Eun, Y., Kim, I.-Y., Han, K., Lee, K. N., Lee, D.-Y., Shin, D. W., Kang, S., Lee, S., Cha, H.-S., Koh, E.-M., Lee, J., & Kim, H. (2021). Association between Female Reproductive Factors and Gout: A Nationwide Population-based Cohort Study of 1 Million Postmenopausal Women. Arthritis Research & Therapy, 23(1), 304. https://doi.org/10.1186/s13075-021-02701-w
  10. Facchini, F., Chen, Y.-D. I., Hollenbeck, C. B., & Reaven, G. M. (1991). Relationship Between Resistance to Insulin-Mediated Glucose Uptake, Urinary Uric Acid Clearance, and Plasma Uric Acid Concentration. JAMA, 266(21), 3008–3011. https://doi.org/10.1001/jama.1991.03470210076036
  11. Fam, A. G. (1998). Gout in the Elderly. Drugs & Aging, 13(3), 229–243. https://doi.org/10.2165/00002512-199813030-00006
  12. Fitz Gerald, J. D., Dalbeth, N., Mikuls, T., Brignardello‐Petersen, R., Guyatt, G., Abeles, A. M., et al. (2020). 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis & Rheumatology, 72(6), 879–895. https://doi.org/10.1002/art.41247
  13. Gong, M., Wen, S., Nguyen, T., Wang, C., Jin, J., & Zhou, L. (2020). Converging Relationships of Obesity and Hyperuricemia with Special Reference to Metabolic Disorders and Plausible Therapeutic Implications. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 943. https://doi.org/10.2147/DMSO.S232377
  14. Indonesian Rheumatology Association (2018). Rekomendasi Pedoman Diagnosis dan Pengelolaan Gout. Indonesian Rheumatology Association. Jakarta
  15. Jick, H., & Porter, J. B. (1981). Potentiation of Ampicillin Skin Reactions by Allopurinol or Hyperuricemia. The Journal of Clinical Pharmacology, 21(10), 456–458. https://doi.org/10.1002/j.1552-4604.1981.tb01749.x
  16. Liu, L., Zhao, T., Shan, L., Cao, L., Zhu, X., & Xue, Y. (2021). Estradiol Regulates Intestinal ABCG2 to Promote Uurate Excretion Via the PI3K/Akt Pathway. Nutrition & Metabolism, 18, 63. https://doi.org/10.1186/s12986-021-00583-y
  17. Mak, V. P., Siu, A. M., Choi, S. Y., Jun Ahn, H., & Lim, S. Y. (2019). Patterns of Health Care Utilization of Gout Patients in Hawai‘i-high Rates of Emergency Department Utilization as Compared to Rheumatoid Arthritis. PLoS ONE, 14(8), e0220978. https://doi.org/10.1371/journal.pone.0220978
  18. Practitioners T. R. A. C. of general. (2016). The management of gout: Much has changed. Australian Family Physician; The Royal Australian College of General Practitioners. Retrieved August 12, 2023, from https://www.racgp.org.au/afp/2016/may/the-management-of-gout-much-has-changed
  19. Qurie, A., Preuss, C. V., & Musa, R. (2023). Allopurinol. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK499942/
  20. Salvatore, T., Pafundi, P. C., Galiero, R., Gjeloshi, K., Masini, et al. (2020). Metformin: A Potential Therapeutic Tool for Rheumatologists. Pharmaceuticals, 13(9), 234. https://doi.org/10.3390/ph13090234
  21. Scheen, A. J. (2005). Diabetes Mellitus in The Elderly: Insulin Resistance and/or Impaired Insulin Secretion? Diabetes & Metabolism, 31 Spec No 2, 5S27-25S34. https://doi.org/10.1016/s1262-3636(05)73649-1
  22. Simão, A. N. C., Lozovoy, M. A. B., & Dichi, I. (2012). The Uric Acid Metabolism Pathway as a Therapeutic Target in Hyperuricemia Related to Metabolic Syndrome. Expert Opinion on Therapeutic Targets, 16(12), 1175–1187. https://doi.org/10.1517/14728222.2012.723694
  23. Vazirpanah, N., Ottria, A., van der Linden, M., Wichers, C. G. K., Schuiveling, M., van Lochem, E., et al (2019). mTOR Inhibition by Metformin Impacts Monosodium Urate Crystal-induced Inflammation and Cell Death in Gout: A Prelude to a New add-on Therapy? Annals of the Rheumatic Diseases, 78(5), 663–671. https://doi.org/10.1136/annrheumdis-2018-214656
  24. Yamamoto, T., Moriwaki, Y., Takahashi, S., Tsutsumi, Z., & Hada, T. (2001). Effect of Furosemide on Renal Excretion of Oxypurinol and Purine Bases. Metabolism: Clinical and Experimental, 50(2), 241–245. https://doi.org/10.1053/meta.2001.19489
  25. Zhang, J., Jin, C., Ma, B., Sun, H., Chen, Y., et al. (2023). Global, Regional and National Burdens of Gout in the Young Population from 1990 to 2019: A Population-based Study. RMD Open, 9(2), e003025. https://doi.org/10.1136/rmdopen-2023-003025