Abstract
A dosage of 300 mg/d of allopurinol was not effective in reducing pain or improving activities of daily living in chronic pancreatitis. Allopurinol prevents the generation of oxygen-derived free radicals by inhibiting xanthine oxidase. The purpose of this study was to determine whether allopurinol is effective in reducing pain of chronic pancreatitis. Thirteen patients with chronic pancreatitis who were experiencing abdominal pain requiring medication at least three times each week entered a randomized, double-blind, two-period crossover clinical trial. Patients evaluated their pain daily using a categorical pain intensity scale, numeric pain intensity scale, and a visual analog scale, and weekly completed a McGill Pain Questionnaire and activities of daily living (ADL) questionnaire. The mean baseline score of pain was approx 50% of most severe pain in all scoring systems. There was no significant decrease in pain associated with allopurinol compared to the placebo (p = 0.24-0.75). In addition, there was no benefit in terms of ADL score associated with allopurinol compared with placebo (p = 0.32). Mean uric acid level was decreased by 1.15 mg/dL while patients were taking allopurinol, compared to when they were taking placebo (p = 0.007).
MeSH Terms
Abdominal Pain/chemically induced
Activities of Daily Living
Adult
Allopurinol/administration & dosage,adverse effects,therapeutic use
Ankle/pathology
Blood Cell Count
Chronic Disease
Cross-Over Studies
Diarrhea/chemically induced
Double-Blind Method
Enzyme Inhibitors/administration & dosage,adverse effects,therapeutic use
Exanthema/chemically induced
Face/physiopathology
Female
Humans
Joints/physiopathology
Liver Function Tests
Male
Middle Aged
Nausea/chemically induced
Pain/drug therapy,etiology
Pain Measurement
Pancreatitis/complications,drug therapy
Placebos
Prospective Studies
Uric Acid/metabolism
Vomiting/chemically induced
Chemicals
Enzyme Inhibitors
Placebos
Uric Acid
Allopurinol
Authors & Affiliations
6 authors, click to expand affiliations / ORCID
Banks P A
Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Hughes M
Ferrante M
Noordhoek E C
Ramagopal V
Slivka A
References (15)
15 references, click to expand
-
Long-term oral opioid therapy in patients with chronic nonmalignant pain.
J Pain Symptom Manage. 1992 Feb;7(2):69-77
PMID: 1573287
-
Recalcitrant pancreatitis: eventual control by antioxidants.
Pancreas. 1987;2(4):489-94
PMID: 3628241
-
Pancreatic interstitial pH in human and feline chronic pancreatitis.
Gastroenterology. 1995 Nov;109(5):1639-45
PMID: 7557149
-
Biology of disease: free radicals and tissue injury.
Lab Invest. 1982 Nov;47(5):412-26
PMID: 6290784
-
Pancreatic tissue fluid pressure in chronic pancreatitis. Relation to pain, morphology, and function.
Scand J Gastroenterol. 1990 Oct;25(10):1046-51
PMID: 2263877
-
Oxygen derived free radicals in patients with chronic pancreatic and other digestive diseases.
J Clin Pathol. 1990 May;43(5):403-5
PMID: 1695229
-
Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial.
Aliment Pharmacol Ther. 1990 Aug;4(4):357-71
PMID: 2103755
-
The short-form McGill Pain Questionnaire.
Pain. 1987 Aug;30(2):191-7
PMID: 3670870
-
Dietary antioxidants and chronic pancreatitis.
Hum Nutr Clin Nutr. 1986 Mar;40(2):151-64
PMID: 3957720
-
The West Haven-Yale Multidimensional Pain Inventory (WHYMPI).
Pain. 1985 Dec;23(4):345-56
PMID: 4088697
-
Compartment syndrome in experimental chronic obstructive pancreatitis: effect of decompressing the main pancreatic duct.
Br J Surg. 1994 Feb;81(2):259-64
PMID: 8156353
-
Oxygen-derived free radicals and acute pancreatitis: a review.
Acta Physiol Scand Suppl. 1986;548:109-18
PMID: 3529821
-
Pancreatic tissue fluid pressure during drainage operations for chronic pancreatitis.
Scand J Gastroenterol. 1990 Oct;25(10):1041-5
PMID: 2263876
-
Role of oxygen-derived free radical scavengers in the treatment of recurrent pain produced by chronic pancreatitis. A new approach.
Arch Surg. 1991 Sep;126(9):1109-14
PMID: 1929842
-
Evaluation of pancreatic tissue fluid pressure and pain in chronic pancreatitis. A longitudinal study.
Scand J Gastroenterol. 1990 May;25(5):462-6
PMID: 2359973