Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
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Randomized Controlled Trial Multicenter Study Comparative Study
Placebo-controlled double-blind dose-response study of the non-purine-selective xanthine oxidase inhibitor febuxostat (TMX-67) in patients with hyperuricemia (including gout patients) in japan: late phase 2 clinical study.
Allopurinol has been widely used for the treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat has been identified as a potentially safe and efficacious alternative. ⋯ Febuxostat can safely reduce serum uric acid levels to 6.0 mg/dL or less in 80% or more of patients with hyperuricemia (including gout) at doses of 40 mg/d or higher.
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Randomized Controlled Trial Comparative Study
An allopurinol-controlled, randomized, double-dummy, double-blind, parallel between-group, comparative study of febuxostat (TMX-67), a non-purine-selective inhibitor of xanthine oxidase, in patients with hyperuricemia including those with gout in Japan: phase 3 clinical study.
Allopurinol has been widely used for treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat is potentially a safe and efficacious alternative. ⋯ Febuxostat at 40 mg/d demonstrated more potent hypouricemic effects than allopurinol at 200 mg/d, was efficacious regardless of medical history of gout, and is considered safe for treatment of hyperuricemia.
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Case Reports
Five consecutive cases of a cutaneous vasculopathy in users of levamisole-adulterated cocaine.
Five patients with an antineutrophil cytoplasmic antibody (ANCA)-associated cutaneous vasculopathy secondary to levamisole-adulterated cocaine were prospectively followed up at a single hospital. All patients presented with retiform purpura, with ear involvement being the most characteristic finding. Cocaine metabolites were present on urine toxicology screening, with 2 of 4 of those tested also being positive for levamisole. ⋯ Improvement of skin lesions and laboratory findings occurred with cessation of cocaine; however, arthralgias and other complications developed. Levamisole-adulterated cocaine is a cause of a cutaneous vasculopathy associated with characteristic laboratory and clinical features that allow it to be distinguished from classic ANCA-associated small-vessel vasculitides. The chronic sequelae of this syndrome and the potential role for immunosuppression are yet to be completely defined.
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Editorial Comment
The growing complexity of the pathology associated with cocaine use.