EXCELLENT URICOSURIC EFFICACY OF BENZBROMARONE IN CYCLOSPORINE-A-TREATED RENAL-TRANSPLANT PATIENTS - A PROSPECTIVE-STUDY

Patients on cyclosporin A (CsA) often develop hyperuricaemia and gout. In transplant patients the use of uricosuric drugs for treating hyper uricaemia may be preferable to allopurinol because of the known intera ction of the latter with azathioprine. We therefore prospectively stud ied the uricosuric efficacy of 100 mg benzbromarone (Bbr;Desuric(R)) d aily in 25 CsA-treated renal transplant patients with stable graft fun ction and hyperuricaemia (> 359 mumol/l for females, > 491 mumol/l for males). Benzbromarone decreased plasma uric acid from 579 +/- 18 mumo l/l to 313 +/- 24 mumol/l (mean +/- SEM; P < 0.001) and thereby normal ized plasma uric acid in 21 of 25 patients. The remaining four patient s had creatinine clearances between 21 and 25 ml/min, the lowest of th e entire study group. Mean fractional clearance of uric acid increased from 5.4 +/- 0.4% to 17.2 +/- 1.0% (P < 0.001). The relative decrease of plasma uric acid closely correlated with baseline creatinine clear ance (r = 0.67; P < 0.001). CsA trough values were not influenced. Non e of the patients experienced any significant side-effects. As an unex pected find-ing, urinary uric acid excretion increased from 2082 +/- 1 75 mumol/24 h to 3233 +/- 232 mumol/24 h after 4 weeks' treatment with benzbromarone. In conclusion, benzbromarone normalized plasma uric ac id in all CsA-treated renal transplant recipients with a creatinine cl earance > 25 ml/min. Due to its excellent efficacy and lack of signifi cant side-effects, benzbromarone appears to be preferable to allopurin ol in CsA-treated renal transplant recipients with a creatinine cleara nce over 25 ml/min.