Gout Drug May Prevent Kidney Damage Caused by Diabetes

Gout has been making quite a stir in news recently. Between a new classification system and a study showing that a common food can cause painful flares, this form of arthritis is getting quite a bit of attention. Now comes word that a drug used to treat gout could also be effective for another damaging condition.

Allopurinol, marketed under the name Zyloprim, is typically prescribed to reduce uric acid in the blood that can buildup and lead to gout. A small study found that the drug can also help prevent kidney damage from nephropathy, or kidney disease. The disease develops in about 38% of patients with diabetes and takes prominence in those with type 1 instead of type 2, the National Kidney Foundation reports.

“The preliminary work that led to this study examined large databases for factors that were predictors for progression of nephropathy. Regardless of the models used or the risk factors evaluated, the level of uric acid always seemed to be a strong predictor of nephropathy,” Ildiko Lingvay, MD, said in a news release. “The higher the uric acid levels, the more likely it was that the nephropathy was progressing, hence the idea of using allopurinol, which lowers uric acid levels.”

A team from the University of Texas Southwestern Medical Center (UT Southwestern) has started an international three-year clinical trial to see if using the drug in the early stages of kidney disease can prevent kidney damage in patients with type 1 diabetes. The study participants have nephropathy and will be treated with either allopurinol or a placebo, in addition to an angiotensin receptor blocker or an angiotensin converting enzyme (ACE) inhibitor — the standard drug therapy for kidney disease.

“Diabetes-related nephropathy is the No. 1 reason for dialysis in the United States and new approaches are needed to prevent progression of the disease. The current standard of care is useful, but clearly not enough. We can do better,” continued Lingvay, an associate professor of Internal Medicine, Division of Endocrinology, and Clinical Sciences at UT Southwestern.

Notably, multiple other trials are testing allopurinol for nephropathy across the US as well as in Canada and Europe. This isn’t the first time that a gout medication has been used in other specialties. Just recently two prescriptions were found to protect against alcoholic liver inflammation.

To reiterate, the UT Southwestern study will last for three years, at which point they will hopefully deliver some good news.

“What nice about this study is that we are repurposing an old drug that is cheap and has a demonstrated safety record,” Lingvay concluded.