Allopurinol in addition to 5-aminosalicylic acid based drugs for the maintenance treatment of ulcerative colitis.
BACKGROUND
To investigate the value of combined treatment with allopurinol and 5-aminosalicylic (5-ASA) based drugs as maintenance treatment for ulcerative colitis (UC).


METHODS
199 patients with UC in remission but with active disease during the preceding 3 years were included. Allopurinol 100 mg twice daily or placebo was added to the 5-ASA based maintenance treatment. Clinical and endoscopic follow up was performed after 1, 6 and 12 months.


RESULTS
Intention-to-treat analysis after 6 and 12 months showed similar results in both groups. A log-rank test showed that 77% in the allopurinol compared to 59% in the placebo group were still in remission after 6 months (P=0.0083) and 62% and 53% after 12 months, respectively (P=0.0936). This was mainly due to a higher than expected number of relapses during the first 3 months in the placebo group. After the first 3 months, the rate of relapse in each group was similar.


CONCLUSIONS
It appears possible that allopurinol in combination with 5-ASA is better than 5-ASA alone for a 6-month, but not a 12-month period. This has to be verified in further dose-ranging studies.
Järnerot
G
G
Division of Gastroenterology, Orebro Medical Centre Hospital, Linköping, Sweden. gunnar.jarnerot@orebroll.se
Ström
M
M
Danielsson
A
A
Kilander
A
A
Lööf
L
L
Hultcrantz
R
R
Löfberg
R
R
Florén
C
C
Nilsson
A
A
Broström
O
O
D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000963:Antimetabolites / Q000008:administration & dosage / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012008:Recurrence; D013548:Sweden
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000963:Antimetabolites; D019804:Mesalamine; D000493:Allopurinol