» New Information About Gout

New Information About Gout

If you are a gout sufferer or know someone who is...this information may be of interest to you. The data comes from many studies around the world on gout and was presented at a special meeting. The meeting was the 2011 Annual Congress of the European League Against Rheumatism, also known as EULAR.

Gout is a disease that involves the build-up of uric acid in the body. Uric acid is a normal chemical in the blood that comes from the breakdown of other chemicals in the body tissues. Everyone has some uric acid in his blood.

As your immune system tries to get rid of the crystals, inflammation develops. For the person with too much uric acid, this inflammation can cause painful arthritis. In fact, gout was the first disease in which researchers recognized that crystals in the synovial (joint) fluid could be the cause of joint pain.

Many gout patients have a combination of overproduction and under-excretion of uric acid. Their bodies create too much uric acid and have problems getting rid of it. More than 90 percent of people with gout have kidneys that don't effectively get rid of uric acid.

This combination of problems can happen with drinking alcohol, especially beer. The more alcohol the patient drinks, the worse the problem is. Alcohol both raises uric acid levels in the body and impairs the kidneys' ability to excrete the buildup.

Sometimes the increase in uric acid is caused by certain kinds of drugs, such as diuretics, cyclosporine, and low-dose aspirin. Other medical conditions, such as obesity, hypertension, and diabetes, can also make some people more likely to develop gout.

Gout cannot be cured, but it can be very successfully treated. The main goal of treating gout is to reduce the amount of urate in the blood. During the acute or early phase of a gouty attack, doctors prescribe medicines called colchicine, certain nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids to decrease swelling and relieve pain.

All of these drugs work quickly and are considered very effective. But that's where the results of this report come in. Studies show that only about one-third of all patients in Europe who get these medications have normal serum uric acid levels.

Not too surprising, quality of life is lower when gout is not under good control. Swollen, tender, and painful joints can be very debilitating. Patients say the pain is so bad the joint can't even stand the slightest touch. Even the weight of a sheet in bed at night causes excruciating pain.

Walking and standing are almost impossible during an acute flare-up if the legs or feet are affected. Many patients have flu-like symptoms, including fever and chills. The pain may go away on its own in a few hours, or it may take a few weeks. Understandably, work and social life suffer.

For patients taking the newer medications (e.g., pegloticase), there is good news. In a study in the United States, 42 per cent had normal serum uric acid levels after six months. They could stop taking the drug for periods of time while still maintaining normal levels of uric acid.

These new treatments called uricase therapy are used for patients who don't respond to other forms of treatment. Uricase therapy involves the use pig and baboon enzymes that can break down uric acid easily. The use of these therapies is still in the study phase in the U.S..

There were two other major findings reported at the EULAR meeting. One was that combining two medications (lesinurad and allopurinol) seems to be much more effective than just taking allopurinol. Allopurinol is another group of medications available to lower urate levels in the body. Zyloprim is the brand name for allopurinol. Other allopurinol drugs on the market include Allohexal, Allosig, Progout, and Zyloric.

And one final tidbit of information. Sugar-sweetened drinks are recognized now as a risk factor for developing gout in some people. Drinking four or more beverages each day containing high levels of corn sweetener (corn syrup) or other sugar compounds significantly increases the risk of gout.

The main take-away point from the EULAR gout studies is this. Even with more modern drug treatments, gout can still be a chronic disease with a significant daily burden for many people. Continued research is needed to find better ways to control the disease, the disease process, and the effects of the disease.

Reference: Gout Studies at EULAR: True Disease Burden and New Treatments. In The Journal of Musculoskeletal Medicine. July 7, 2011. Vol. 28. No. 7. Pp. 1-2.

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