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Oxypurinol May Not Improve Heart Failure

However, patients with high serum uric acid may benefit from the xanthine oxidase inhibitor

THURSDAY, June 12 (HealthDay News) -- Treatment with oxypurinol didn't result in improvements in individuals with moderate to severe heart failure, although the underlying mechanism of oxypurinol may benefit patients with elevated serum uric acid, according to the results of a study published in the June 17 issue of the Journal of the American College of Cardiology.

Joshua M. Hare, M.D., of the University of Miami Miller School of Medicine, and colleagues analyzed data from 405 patients with symptomatic heart failure and systolic dysfunction who were randomized to placebo or oxypurinol for 24 weeks. This xanthine oxidase inhibitor is the active derivative of allopurinol.

The researchers found no difference between groups in the percentage of patients who improved, stayed the same, or worsened. The oxypurinol group showed a trend toward worsening. However, within the entire treatment group, those who were unchanged or improved had greater serum uric acid reductions compared to those who worsened.

"Based on the results of [this] study, the future of xanthine oxidase inhibition in the treatment of heart failure remains unclear, but the relatively longstanding clinical safety profile with allopurinol and the potential value of serum uric acid testing can be an important reassurance for future investigations. The logical next step is to pursue the next phase of clinical study to examine the effectiveness of xanthine oxidase inhibition in patients with advanced heart failure and elevated serum uric acid," writes the author of an accompanying editorial.

Several of the study authors have financial ties to Cardiome Pharma Corp., and the company provided funding for the study.

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