Allopurinol is the cornerstone of pharmacologic urate-lowering therapy for recurrent gouty arthritis. Although this drug is inexpensive and efficacious, it may cause rare, but life-threatening, cutaneous drug eruptions: the allopurinol hypersensitivity syndrome.1 Mortality rates for individuals experiencing allopurinol hypersensitivity can exceed 30% and long-term morbidity is common.2 In this issue of JAMA Internal Medicine, Yang et al2 demonstrate that in Taiwan, both allopurinol prescribing and hypersensitivity reactions are on the rise. Their findings highlight the value of judicious, guideline-based hyperuricemia management throughout the world.
Stern RJ. Reducing Life-Threatening Allopurinol Hypersensitivity. JAMA Intern Med. 2015;175(9):1558. doi:10.1001/jamainternmed.2015.3546