Allopurinol in addition to 5-aminosalicylic acid based drugs for the maintenance treatment of ulcerative colitis

Aliment Pharmacol Ther. 2000 Sep;14(9):1159-62. doi: 10.1046/j.1365-2036.2000.00821.x.


Background: To investigate the value of combined treatment with allopurinol and 5-aminosalicylic (5-ASA) based drugs as maintenance treatment for ulcerative colitis (UC).

Methods: 199 patients with UC in remission but with active disease during the preceding 3 years were included. Allopurinol 100 mg twice daily or placebo was added to the 5-ASA based maintenance treatment. Clinical and endoscopic follow up was performed after 1, 6 and 12 months.

Results: Intention-to-treat analysis after 6 and 12 months showed similar results in both groups. A log-rank test showed that 77% in the allopurinol compared to 59% in the placebo group were still in remission after 6 months (P=0.0083) and 62% and 53% after 12 months, respectively (P=0.0936). This was mainly due to a higher than expected number of relapses during the first 3 months in the placebo group. After the first 3 months, the rate of relapse in each group was similar.

Conclusions: It appears possible that allopurinol in combination with 5-ASA is better than 5-ASA alone for a 6-month, but not a 12-month period. This has to be verified in further dose-ranging studies.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Allopurinol / administration & dosage
  • Allopurinol / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antimetabolites / administration & dosage
  • Antimetabolites / therapeutic use*
  • Colitis, Ulcerative / drug therapy*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Mesalamine / administration & dosage
  • Mesalamine / therapeutic use*
  • Middle Aged
  • Recurrence
  • Sweden


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antimetabolites
  • Mesalamine
  • Allopurinol