Injected Drug May Be New Weapon Against Gout
Gouty Arthritis Explained. Gout Treatment, Gouty Arthritis Diet, Symptoms, Treatments, Herbal Remedies, Stages, Management and Exercises All Covered
Gouty Arthritis is a form of inflammatory arthritis that can be very painful and debilitating if left untreated. It is caused by the accumulation of uric acid crystals in joints, often leading to swelling, redness, and extreme tenderness in the affected area. If you are looking for ways to treat your gouty arthritis naturally then this article will provide you with information on the diet, treatments, stages, herbal remedies and exercises that could help improve your overall health condition.
The first step to managing gouty arthritis is understanding what it is and how it affects your body. Gouty Arthritis is a type of arthritis caused by an overload of uric acid in the blood which then crystallizes in tissues such as around the joints resulting in inflammation.
Learn more: Gouty Arthritis Explained. Gout Treatment, Gouty Arthritis Diet, Symptoms, Treatments, Herbal Remedies, Stages, Management and Exercises All Covered
Short- and long-term strategies to manage gout pain
Gout is a kind of arthritis that causes painful and stiff joints and can strike suddenly, causing excruciating pain and swelling. “Gout usually affects a big toe, but can also attack the ankle, knee, foot, elbow or fingers,” said Dr. Stuart Weisman, rheumatology specialist at Boulder Medical Center. Dr. Weisman recently spoke during a free lecture sponsored by Boulder Community Health.
“Gout is a type of arthritis that occurs when you have high levels of uric acid in your blood,” explained Dr. Weisman. “Over time, the uric acid forms needle-sharp crystals that collect around your joints and soft tissues. Eventually, these crystals trigger a gout attack.”
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| About Gout: Managing and Preventing Attacks |
Symptoms of gout include:
- Sudden, intense and excruciating joint pain typically the big toe or ankle, sometimes the knee, hand or wrist
- The affected joint becomes so tender that even the slightest touch can be unbearable
- Swelling, inflammation with the feeling that the joint is very warm or even hot
- Red or purple skin around the affected joint
- Fever in more extreme cases
“Fortunately, gout will clear in time and there is a lot we can do to prevent future attacks,” said Dr. Weisman.
Strategies for relief during gout attacks
Gout attacks can be quite severe, so it’s good to know how to quell the pain as soon as possible, said Dr. Weisman. He offered a few options for relief of gout flare-ups:
- Over-the-counter drugs
Take nonsteroidal anti-inflammatory drugs (NSAIDS) early in an attack and at a maximum dose. For example, you could take a naproxen dosage of 500MG two times a day. - Corticosteroids
Your doctor can prescribe a 5- to 14-day course of corticosteroids to reduce inflammation. - Colchicine
This medication is best taken at the onset of an attack; prescription colchicine can help decrease pain and swelling.
“All of these options have possible side effects and should not be taken without checking with your doctor first,” Dr. Weisman warned. “It’s also important to note that medications like diuretics, niacin, and event low-dose aspirin can cause your uric acid levels to rise. Be sure to mention that you have gout if your doctor is planning to start you on a new medicine.”
Managing gout — foods to avoid
If you’re prone to gout, the foods you eat and don’t eat, as well as your lifestyle choices can be key in controlling the disease, Dr. Weisman said. Foods that are high in purines, a natural substance that increases the production of uric acid in your body, can trigger gout attacks. Some foods to avoid:
- Sugary foods and beverages
- High-fructose corn syrup
- Organ meats such as liver or tongue
- Red meat, including beef, lamb and pork
- Seafood
- Beer, wine and liquor
“The worst types of seafood are anchovies, herring, sardines, trout, tuna and shellfish,” said Dr. Weisman. “Alcohol exacerbates gout by increasing uric acid production and decreasing excretion of uric acid. In addition, beer adds purines to your blood.”
Lifestyle modifications can prevent gout attacks
The good news about gout is that lifestyle changes can help prevent attacks or at least lessen the severity. A few suggestions from Dr. Weisman:
- Hydrate – water helps remove uric acid from the body and lubricates your joints
- Maintain a healthy weight – this can lower uric acid levels and significantly reduce the risk of gout attacks
- Include nonfat and low-fat dairy foods in your diet
- Eat lots of vegetables
- Get regular exercise — if you are not exercising now, ask your doctor about a plan that is right for you
Dr. Weisman added that “one study showed cherries might reduce the risk of gout attacks. Another suggested that high doses of regular or decaf coffee — four cups a day or more — can be helpful.” Ask your about lifestyle changes that might be helpful.
Also See: Everything There Is to Know About Gout, Home Remedies, Lowering Uric Acid, and Decreasing Painful Attacks, in Addition to More than 100 Tasty and Simple Recipes, with Pictures
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A new approach to preventing gout attacks looks promising for people not already helped by existing treatments.
Researchers are looking at an anti-inflammatory drug called canakinumab (Ilaris) to treat this painful form of arthritis.
Instead of targeting excessively high uric acid levels as existing gout drugs do, the new strategy aims to reduce overall inflammation. The drug goes after a specific inflammatory molecule called interleukin-1.
The result was a 50 percent drop in gout attack risk, the researchers found.
"This was a very large effect," said study lead author Dr. Daniel Solomon, a rheumatologist with Brigham and Women's Hospital in Boston.
He acknowledged it was "very surprising" that the drug packed an equally protective punch whether patients had normal uric acid levels or very high levels.
But Ilaris is unlikely to be the preventive drug of choice any time soon, said Solomon.
For one, it has not yet received approval for gout treatment in the United States. And most patients already achieve risk reduction with standard uric acid-lowering treatments, such as allopurinol (brand names Zyloprim, Aloprim).
What's more, decades-old allopurinol is a cheap daily pill.
"Canakinumab is very expensive," said Solomon. Its main role to date is as a last-ditch treatment for rare, so-called "orphan" diseases. At its current price, he said, "it is not a viable option for most patients with gout."
Also, it must be injected every three months by a caregiver.
Still, Solomon said Ilaris may have a clinical role for patients who don't respond to or tolerate standard medications.
Prior research had shown that interleukin-1B inhibitors can shorten gout attacks, but it wasn't known if they could prevent them, the study authors said.
The new research was funded by Novartis, the maker of Ilaris. The results were published online Sept. 17 in Annals of Internal Medicine.
Gout is the most common form of inflammatory arthritis. When a chemical called uric acid builds up in the body, it triggers the formation of tiny jagged crystals that cause severe joint paint, most often in the foot, particularly the big toe. Gout's prevalence has increased considerably in recent decades.
Learn more: Genes, Not Diet, May Be Key to Gout Flare-Ups
Heart disease and gout often overlap, the researchers noted. To explore whether Ilaris has potential as a preventive measure, investigators conducted a secondary analysis of the so-called Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). This enlisted more than 10,000 heart attack patients to see if Ilaris might help reduce future cardiovascular complications among high-risk individuals.
The researchers found that patients treated with four injections of Ilaris a year faced half the risk for a gout attack, compared with those given a dummy (placebo) treatment, regardless of uric acid levels.
"We have no strong reason to believe that [Ilaris] would be less effective in patients without known heart disease," said Solomon.
Howard Feinberg, a professor of rheumatology at Touro University in Vallejo, Calif., agreed.
Based on the current and prior research, "we can assume that this drug will work for most patients," including those without a history of heart disease, he said.
Feinberg said he "would not recommend its use for someone who did well on older medications" because of its high cost and the need to give it as in injection.
"The type of patient who would benefit the most is someone who was allergic or could not take standard therapy," Feinberg said, mentioning patients with kidney disease. "This treatment is also ideal for someone whose gout could not be controlled on allopurinol or other older therapies."
Learn more: Cure Arthritis Naturally
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