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Mar 23,2009
New FDA-approved drug offers hope for gout sufferers
by Rallie McAllister

Finally, some good news for gout sufferers. Earlier this month, the U.S. Food and Drug Administration approved a new prescription drug that may help reduce painful flare-ups.

 

Sold under the brand name Uloric, the once-daily oral medication is the first new treatment option for gout in more than 40 years.

Gout is a type of arthritis that occurs when a compound known as uric acid accumulates in the joints and forms long, needle-like crystals. These prickly crystals trigger a violent inflammatory reaction in the affected joint tissue, as well as excruciating pain.

Uric acid is produced when the body breaks down purines, substances found in meat and organ meats, seafood and beer. Most healthy individuals are able to excrete excess uric acid in the urine, but many gout sufferers aren't so fortunate — their bodies either make too much uric acid or aren't able to properly excrete it.

The new drug Uloric works by blocking xanthine oxidase, an enzyme responsible for breaking down purines into uric acid. By inhibiting the action of this enzyme, the drug helps lower uric acid levels in the body.

To date, Uloric has been evaluated in clinical trials involving more than 4,000 subjects for up to five years. Although relatively uncommon, side effects of the drug may include liver function abnormalities, nausea, joint pain and rash.

Gout affects more than 5 million people in the United States. While it is most common in men over the age of 40, menopausal women are also at risk.

The condition often involves a single joint initially. In many cases, the joint of the big toe is targeted, but the condition may occur in other joints of the feet, ankles, knees, wrists or hands.

The first attack usually occurs overnight and strikes without warning. Individuals with gout may awaken to excruciating pain and find the affected joint red, hot and swollen.

Without medical intervention, the pain and other symptoms gradually subside after a week or two, leaving the affected joint apparently normal. While some people may suffer only a single attack, others may experience regular flare-ups.

Left untreated, repeated attacks can lead to worsening pain and permanent joint damage. Over time, the accumulation of uric acid can cause other problems throughout the body.

In the skin, it can create unsightly lumps, known as tophi, and in the kidneys it can lead to the formation of kidney stones. Scientists at the University of Pittsburgh reported that elevated uric acid levels significantly increase the risk of experiencing a heart attack.

If you suffer from gout, a few simple strategies can help reduce the likelihood of future flare-ups. Drinking more water is a good place to start, since uric acid is more likely to crystallize in joints when the body is dehydrated.

While it's important to drink plenty of water, sodas and alcohol should be consumed in moderation, if at all. In a recent issue of the British Medical Journal, researchers reported their findings that men who drank two or more servings of sugar-sweetened sodas daily were 85 percent more likely to experience an attack than those who consumed less than one serving a month.

Consuming certain types of alcohol, especially in excess, can also bring on the condition. Harvard scientists found that men who drank the equivalent of four or five alcoholic beverages daily were 2.5 times more likely to develop gout than those who abstained.

Men who consumed just one alcoholic beverage each day had a 30 percent greater risk than their non-drinking counterparts. While beer and liquor serve as triggers, wine is not associated with an increased risk.

As surprising as it may seem, coffee has a protective effect for gout sufferers, as it helps lower uric acid levels in the body. In a study of more than 50,000 male health professionals, researchers found that the risk of developing gout was roughly 40 percent lower for men who drank four to five cups a day and nearly 60 percent lower for men who drank at least six cups daily.

Spiking your coffee with milk may further reduce the chances of a flare-up. The results of a study published in The New England Journal of Medicine suggest that drinking more than two glasses of milk daily can result in a 50 percent reduction in risk.

Gout is a serious condition, but it is entirely treatable. With proper medical management and a few changes in your diet, you can attack gout before it attacks you.

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim."

Copyright 2009 Creators Syndicate Inc.
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