Cheap gout drug proves useful for heart pain

A drug used for more than 40 years to treat gout could also offer a cheap alternative to more modern heart drugs for patients with chronic chest pain, scientists said on Tuesday.

Researchers from the University of Dundee said that studies on allopurinol, a generic gout drug, showed it helped people suffering from angina to exercise more and delayed the time until their chest pain started.

“What is exciting is that it looks as if allopurinol may work by protecting the heart from oxygen starvation,” said Peter Weissberg, medical director of the British Heart Foundation charity, which funded the study. “If that is the case, then it raises the possibility that it could help the heart in other situations as well, such as after a heart attack.”

Angina is the most common symptom of heart disease, affecting around two million people in Britain and many millions more around the world. It causes people to get a pain in their chest when they exercise.

Allan Struthers of the University of Dundee and a team of fellow scientists asked 65 patients with chronic angina to exercise on a treadmill after treating some of them with allopurinol and others with a dummy pill, or placebo.

The results of the study were published in The Lancet medical journal on Tuesday.

Those who had the real drug were able to walk for 25 percent longer than those on placebo before they complained of chest pain. And electrical recordings of the patients’ hearts showed that allopurinol enabled the heart to work for longer before showing signs of oxygen deprivation.

“Allopurinol is inexpensive compared with some other antianginal drugs,” Struthers wrote in the study, and also has “a favorable long-term safety record.”

He compared it with Ranexa, or ranolazine, from Roche and Gilead Sciences’, and with ivabradine, which is sold under the brand names Corlentor and Coraxan by Servier, France’s largest privately-owned pharmaceuticals company.

Struthers added that compared with some older antianginal drugs such as nitrates and beta-blockers, patients were able to tolerate allopurinol better because it does not reduce blood pressure or heart rate. It also has fewer side-effects like headaches and tiredness that often occur with other medicines.

“There are several effective medicines out there for controlling angina, but it’s helpful for doctors to have another option to turn to for patients who don’t respond well to existing drugs,” said the BHF’s Weissberg.

SOURCE:  Lancet, online June 8, 2010.