{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T05:53:23Z","timestamp":1793944403606,"version":"4.8.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Gout is associated with increased ischaemic cardiovascular disease (CVD). The effects of allopurinol and colchicine on CVD risk remain debated. This study aims to investigate the interplay between these factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This was a pharmaco-epidemiological study, including adult gout patients prescribed allopurinol between October 2015 and December 2022. Cardiovascular disease was operationalized as a new prescription for a platelet aggregation inhibitor. Incidence densities (CVD\/100 patient-years) were compared using incidence rate ratios (IRRs). Time periods based on allopurinol use were defined: (i) before initiation, (ii) first 30 days after initiation, (iii) continued use, (iv) first 30 days after discontinuation, and (v) prolonged discontinuation. Effect modification by initial allopurinol dose\u2014low (&amp;lt;300\u2005mg) or high (\u2265300\u2005mg)\u2014and concomitant colchicine use were assessed. Included were 84,582 patients [77% male, mean age 66 years (standard deviation 13.4)], with 122 659 treatment episodes and 13 568 CVD events. Cardiovascular disease IRRs for Periods 2\u20135 (reference Period 1) were: 1.51 [95% confidence interval (CI) 1.29\u20131.77], 1.07 (95% CI 1.03\u20131.12), 1.20 (95% CI 1.02\u20131.43), and 0.94 (95% CI 0.88\u20131.00), respectively. The increased CVD risk after allopurinol initiation was dose-dependent (IRR: low dose 1.69; 95% CI 1.31\u20132.18; high dose 3.92; 95% CI 2.73\u20135.63). Concomitant colchicine use attenuated this risk: IRR 1.02 (95% CI 0.78\u20131.32) for low-dose and 1.18 (95% CI 0.65\u20132.16) for high-dose allopurinol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Allopurinol initiation was associated with a substantial and dose-dependent increase in CVD risk in gout patients, especially in the first 30\u201390 days and at dosages \u2265300\u202fmg\/day. Concomitant colchicine use reduced this risk. Discontinuation of allopurinol was not associated with CVD risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf513","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T11:36:56Z","timestamp":1754998616000},"page":"682-690","source":"Crossref","is-referenced-by-count":4,"title":["Ischaemic cardiovascular risk with allopurinol and protective effect of colchicine in gout: a Dutch nationwide pharmaco-epidemiological study"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7991-6112","authenticated-orcid":false,"given":"Iris Rose","family":"Peeters","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Sint Maartenskliniek , Hengstdal 3, 6574 NA Ubbergen, Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike H M","family":"Wientjes","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sint Maartenskliniek , Hengstdal 3, 6574 NA Ubbergen, Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isla S","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"MEMO Research, Division of Cardiovascular Research, University of Dundee , Dundee ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3385-8807","authenticated-orcid":false,"given":"Merel A A","family":"Opdam","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sint Maartenskliniek , Hengstdal 3, 6574 NA Ubbergen, Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Flendrie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sint Maartenskliniek , Hengstdal 3, 6574 NA Ubbergen, Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calin D","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sint Maartenskliniek , Hengstdal 3, 6574 NA Ubbergen, Nijmegen ,","place":["The Netherlands"]},{"name":"Department of Rheumatology, Radboudumc , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayleigh M","family":"van de Wiel","sequence":"additional","affiliation":[{"name":"IQVIA Solutions B.V , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Vojinovic","sequence":"additional","affiliation":[{"name":"IQVIA Solutions B.V , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo A B","family":"Joosten","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboudumc , Nijmegen ,","place":["The 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