Correspondence (letter to the editor): Importance in Neuroprotection

The authors add to the various recommendations (guidelines) that have been published in recent years (1): in addition to those of the European League against Rheumatism (EULAR) and the American College of Rheumatology (ACR), the guidelines of the American College of Physicians (ACP) were published in March 2017 (2). The difference is that the rheumatological guidelines are based on the so-called “treat to target” (T2T) principle. The ACP‘s recommendations, by contrast, favor the “treat to avoid symptoms” principle (T2aS).

What is the extent to which the serum concentration of uric acid can be lowered without incurring long term side effects? The known antioxidant effects of uric acid are of importance in neuroprotection. Gout, for example, rules out multiple sclerosis (3). Even though the severe cutaneous side effects of allopurinol are rare, widespread treatment using allopurinol raises the question of potential prophylactic measures. The pharmacogenetic study of the genotype in the HLS B*5801 system provides a relevant opportunity in this context, at the start of allopurinol treatment (4).