Using allopurinol to improve the outcome for stroke patients in the UK

Fifth Joint Stroke Association/BHF Programme Grant: Xanthine oxidase Inhibition for improvement of Long-term Outcomes Following Ischaemic Stroke and Transient ischaemic attack (XILO-FIST). (fifth call)

Stroke causes more than 41,000 deaths in the UK each year. There are around 152,000 strokes in the UK each year and nearly 1.2 million people living in the UK have had a stroke. These people are at high risk of another stroke, and also of a decline in their brain function, leading to a poor quality of life. A pioneering joint research project totalling nearly £1million is being funded together by the British Heart Foundation and the Stroke Association to investigate whether a medicine called allopurinol, which is currently used to treat gout, can offer any benefit to patients who have suffered a stroke. The research team will run a clinical trial of 464 stroke patients from around the UK for two years. The participants will be randomly assigned allopurinol treatment or a placebo (dummy) treatment. Neither the participants nor the clinical researchers involved in the study will know which option a patient has been allocated, improving the quality and reliability of the results. During and after treatment, the patients will be monitored closely to look for any signs of stroke recurrence or a decline in brain function. This monitoring will involve biological and physiological tests such as looking at their white matter - a type of tissue in the brain - on MRI scans and measurement of patients’ blood pressure, as well as assessments of their brain function. Disease of the white matter, as well as high blood pressure and thickening of the left ventricle (one of the pumping chambers in the heart) are all thought to increase the risk of another stroke, and contribute to a decline in brain function. The researchers are looking to see whether allopurinol reduces disease progression in the white matter, reverses left ventricular thickening in the heart and reduces high blood pressure. At the end of the 5-year study the researchers will look to see if allopurinol improves a patient’s outcome after a stroke.