title: Prednisone in Uric Acid lowering in Symptomatic Heart Failure Patients With Hyperuricemia (PUSH-PATH) study.
abstract: BACKGROUND
  Chronic drug interactions that exist between symptomatic congestive heart failure (CHF) therapy and pharmacologic agents used for hyperuricemia and gout are a challenging problem in clinical practice. Recent observational studies showed that prednisone can induce a potent diuresis and lower serum uric acid concentration (SUA) in CHF. We therefore designed a randomized study to compare the effect of prednisone with allopurinol on SUA in symptomatic CHF patients with hyperuricemia.
  
  
  METHODS
  Thirty-four symptomatic CHF participants with hyperuricemia (≥ 565 μmol/L) were randomized to receive prednisone (1 mg/kg/d, orally) or allopurinol (100 mg, thrice daily, orally) for 4 weeks. The primary outcome measure was change from baseline in SUA. The secondary outcome measures were change from baseline in serum creatinine levels, estimated glomerular filtration rate, daily urine output, body weight, N-terminal pro-B-type natriuretic peptide levels, physician-assessed global clinical status, and New York Heart Association functional class.
  
  
  RESULTS
  Both prednisone and allopurinol greatly lowered SUA rapidly. The overall SUA-lowering effect did not differ between treatment groups during the study period (P = 0.48, 2-way repeated measures analysis of variance). However, prednisone increased estimated glomerular filtration rate and daily urine output, and lowered body weights and N-terminal pro-B-type natriuretic peptide. Consequently, participants treated with prednisone had an improvement in clinical status.
  
  
  CONCLUSIONS
  The study showed that the SUA-lowering effect of prednisone and allopurinol is similar in symptomatic CHF patients. Prednisone might be useful for short-term SUA-lowering in CHF patients with hyperuricemia.
authors: Heart Center, The First Hospital of Hebei Medical University, Hebei Province, China.
authors: Chao
authors: C
authors: Liu
authors: Qingzhen
authors: Q
authors: Zhao
authors: Yuzhi
authors: Y
authors: Zhen
authors: Yanqiu
authors: Y
authors: Gao
authors: Li
authors: L
authors: Tian
authors: Le
authors: L
authors: Wang
authors: Lishuang
authors: L
authors: Ji
authors: Gang
authors: G
authors: Liu
authors: Zhenguo
authors: Z
authors: Ji
authors: Kunshen
authors: K
authors: Liu
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000009:adverse effects / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D004417:Dyspnea / Q000517:prevention & control; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006074:Gout Suppressants / Q000009:adverse effects / Q000627:therapeutic use*; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000187:drug effects; D010446:Peptide Fragments / Q000097:blood / Q000187:drug effects; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D005938:Glucocorticoids; D006074:Gout Suppressants; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D000493:Allopurinol; D003404:Creatinine; D011241:Prednisone