Allopurinol in Patients with Pulmonary Hypertension Associated with Chronic Lung Disease.
allopurinol
chronic lung disease
pulmonary hypertension
right ventricle
Journal
International journal of chronic obstructive pulmonary disease
ISSN: 1178-2005
Titre abrégé: Int J Chron Obstruct Pulmon Dis
Pays: New Zealand
ID NLM: 101273481
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
05
2020
accepted:
15
07
2020
entrez:
9
9
2020
pubmed:
10
9
2020
medline:
29
6
2021
Statut:
epublish
Résumé
Oxidative stress (OS) has been implicated in the development of pulmonary hypertension (PH) and ventricular hypertrophy. Xanthine oxidase is a well-recognised source of reactive oxygen species, which lead to OS. The aim of this proof of concept study was to assess whether allopurinol (xanthine oxidase inhibitor) would reduce right ventricular mass (RVM) in patients with PH-associated chronic lung disease (PH-CLD). We conducted a randomised, double-blind, parallel-group, placebo-controlled trial in patients with PH-CLD (93% COPD, 7% IPF) who were randomly assigned to receive allopurinol or placebo for 12 months. The primary outcome was the mean change in RVM, as assessed by cardiac magnetic resonance imaging (CMRI). Secondary outcomes included quality of life (QOL), spirometry and six-minute walk test (6MWT). Seventy-one patients were recruited: mean age 71 years, mean pulmonary arterial pressure 30 mm Hg, FEV Allopurinol had no overall impact on patients with PH-CLD but had potential benefit in COPD patients with more severe airflow limitation.
Sections du résumé
Background
Oxidative stress (OS) has been implicated in the development of pulmonary hypertension (PH) and ventricular hypertrophy. Xanthine oxidase is a well-recognised source of reactive oxygen species, which lead to OS. The aim of this proof of concept study was to assess whether allopurinol (xanthine oxidase inhibitor) would reduce right ventricular mass (RVM) in patients with PH-associated chronic lung disease (PH-CLD).
Methods
We conducted a randomised, double-blind, parallel-group, placebo-controlled trial in patients with PH-CLD (93% COPD, 7% IPF) who were randomly assigned to receive allopurinol or placebo for 12 months. The primary outcome was the mean change in RVM, as assessed by cardiac magnetic resonance imaging (CMRI). Secondary outcomes included quality of life (QOL), spirometry and six-minute walk test (6MWT).
Results
Seventy-one patients were recruited: mean age 71 years, mean pulmonary arterial pressure 30 mm Hg, FEV
Conclusion
Allopurinol had no overall impact on patients with PH-CLD but had potential benefit in COPD patients with more severe airflow limitation.
Identifiants
pubmed: 32904701
doi: 10.2147/COPD.S260917
pii: 260917
pmc: PMC7457596
doi:
Substances chimiques
Allopurinol
63CZ7GJN5I
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
2015-2024Informations de copyright
© 2020 Liu-Shiu-Cheong et al.
Déclaration de conflit d'intérêts
Dr Liu-Shiu-Cheong reports personal fees from Chiesi, outside the submitted work. Dr Lipworth reports grants, personal fees and non-financial support from Chiesi, Boerhinger Ingeheim, personal fees and non-financial support from AstraZeneca and Thorasys, non-financial support from GSK, and personal fees from Novartis, Sanofi Genzyme, Lupin, Glenmark, Vectura, and Circassia, outside the submitted work. Dr Weir-McCall and Dr Houston have nothing to disclose. Dr Struthers reports grants from British Heart Foundation, during the conduct of the study; and in addition, has a patent issued for the use of xanthine oxidase inhibitors to treat chest pain in angina pectoris. The authors report no other potential conflicts of interest for this work.
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