Apreciação do Alopurinol no tratamento da leishmaniose canina: uma revisão sistemática

Abstract

Canine visceral leishmaniasis (CVL) is a systemic disease of veterinary and public health relevance, with dogs acting as the main domestic reservoir. Allopurinol is widely used in the therapeutic management of CVL, particularly in combined treatment protocols; however, uncertainties remain regarding its safety profile, especially under long-term use. This study aimed to synthesize, through a systematic review, the available evidence on the use of allopurinol in dogs with CVL, with an emphasis on safety outcomes. Searches were conducted in the CAPES Periodicals Portal and PubMed databases, following the PRISMA 2020 guidelines, including publications from January 2013 to December 2023. After applying inclusion and exclusion criteria, 11 studies were included, evaluating allopurinol as monotherapy or in combination with other drugs. Due to methodological heterogeneity, a qualitative synthesis of the findings was performed. Overall, the studies suggest a favorable clinical safety profile in the short and medium term, particularly when allopurinol is used in combination, with renal and hepatic alterations often attributed to the progression of CVL itself. Adverse events related to purine metabolism (such as xanthinuria and xanthine urolithiasis) were rarely investigated systematically, which limits conclusions regarding risks associated with continuous use. Thus, the available evidence supports the cautious and monitored use of allopurinol, with clinical, laboratory, and urinary follow-up, particularly during prolonged treatments.