New Gout Research Stories
“Gout trigger foods are real” … “Patients suspected it was true and now new research shows a connection between gout flares and eating fish (63%), alcohol (47%), red meat (35%) and tomatoes (20%).” The Rheumatology Network in mid-October has a nice splash of gout related research stories including: “Fructose and Gout Don’t Mix,” “Should Gout Patients Avoid Tomatoes?” and “The Economic Burden of Gout.”
The Family Circle of Gout
A belief, and some evidence, has always existed in clinical circles that gout runs in families. Now that belief has been bolstered, and with new details, by a study of 4.2 million Taiwan families where gout is prevalent.
Risk of gout, of course, is largely linked to factors that we can change ourselves, such as lifestyle and diet. The study authors point this out. But how do genetics affect the question of who has the most reason to worry about out these factors?
The more of your first-degree relatives (brother, sister, mom and dad) have gout, the more you are likely to have it. Just one first degree relative means you’re twice as likely to have it as the general population. If you have a twin brother with gout, you have EIGHT times more likelihood of gout.
Genetics is a more significant factor in men than in women, the study found. “Genetic factors contribute one-third in men and one-fifth in women,” says study lead author Dr. Chang-Fu Kuo, of England’s University of Nottingham, and also of ChangGungMemorialHospital, Taoyuan, Taiwan. Source: Medical News Today
Gout Research: Science Turns Against Wine
Dang! I thought wine was fine, but I guess not. A research report published in the February 10 issue of the American Journal of Medicine, says that any alcohol, including wine, can trigger gout attacks. Previous studies pointed only to beer and liquor, but this larger study “was sufficiently powered to find an association with wine too.”
Says the study: “Two drinks in a 24-hour period were associated with about a one-third higher risk of recurrent attack. Seven or eight drinks doubled the risk.”
Earlier studies may have been confounded, say the researchers, by the fact that “wine drinkers tend to have healthier lifestyles,” and eat healthier diets, than people who drink beer. This new and larger study was designed to eliminate that bias from the data.
Gout on the Way Out?
“Could gout go the way of smallpox? Gout has the potential to be a disorder of the past,” according to an encouraging editorial in the prominent medical journal, The Lancet.
Gout: New Info on Foods
“Potato protein extract in weight management bars has shown to help people feel full sooner and longer.” Newswise, the premier science wire service, had a recent story on “12 Foods and Ingredients That May Help Weight Management.” This is not another of those preachy public service announcements telling gout suffers — and everybody else — that they need to lose weight, but specific food recommendations based on the most recent research. Along with tips in more familiar topic areas like dairy protein and dietary fiber and canola oil, the article details the biological benefits of foods ranging from rice protein to Korean pine nut.
A Great Gout News Web Source
“Risk of heart attack and stroke doubles for patients with gout” … “The healthspan of seniors could be extended by controlling the triggers of age-related inflammation” … “Less than half of gout patients reach recommended treatment goal following treatment with allopurinol.” … these are just three of the latest studies, released in October 2013, featured on Medical News Today, a Web site published by MediLexicon International Ltd. They’re located in the U.K. at Bexhill-on-Sea, East Sussex, don’t you just love those English place names?
Medical News Today describes itself as “The number one ranked (Google and Yahoo!) website for medical news. Independent, authoritative and unbiased news from thousands of sources around the globe, divided into over 128 therapy areas (disease/condition categories). One of those therapy areas is an online newsletter just for gout: Gout News
New Info on Pegloticase Gout Relief
Study results published in October 2013 support the use of pegloticase, trade name Krystexxa, for elimination of uric-acid crystal deposits. Known as “tophi,” these deposits cause swelling, deformity and chronic pain in gout sufferers.
It was a study of chronic gout patients with multiple tophi. After six months, 45% of those who got bi-weekly pegloticase injections, and 26% of those getting monthly injections, had “complete resolution of at least one tophi with no new or enlarging tophi.” The best response was in those with serum urate levels below 6 mg/dL, including “complete response in more than 80%” of those who maintained uric acid level below 6 mg/dL for one year.
As one doctor says in the “What’s the Latest in Gout Treatment?” article –scroll down a bit — in our Gout Tips section, “You can shrink the tophi if you give a drug like allopurinol, but it takes a long time, months and sometimes years,” says Dr. Brasington. “But Krystexxa can make this happen a lot faster.”
More Info on the study at: “Pegloticase May Resolve Multiple Tophi in Chronic Gout.”
Some Herbal Medicines for Gout Cause Cancer
“Several herbal medicines traditionally used to treat arthritis, GOUT and inflammation contain aristolochic acid (AA), which causes kidney failure and urothelilal carcinoma of the upper urinary tract,” according to an article, “Link Between Herbal Medicines for Arthritis and Liver Cancer Explained.”
“Although the Food and Drug Administration has been sending warning letters since 2001, products containing AA, such as birthwort, are still sold on the Internet.” Aristolochic acid is a natural product of Aristolochia plants found in herbal remedies and health supplements.
According to an article in the Autust 2013 issue of Science Translational Medicine, “analysis of nine AA-associated” urothelial cell carcinomas “revealed a strikingly high somatic mutation rate,” nearly 19 times higher than the mutation rate for smoking-associated lung cancer and higher than that for “ultraviolet radiation-associated melanoma.
“Our study highlights an unusual genome-wide AA mutational signature…”
Diagnosing and Managing Gout
Always interesting to hear what the doctors are thinking and saying and doing. Instructive July 31, 2013, article: “Diagnosing and Managing Gout – 10 International Recommendations.”
Gout Flare-Ups: “Big Toe Not the Biggest Culprit.”
This falls in the category of “What the….?” A Mayo Clinic study found that even though people usually associate gout with the big toe, patients with the highest risk of flare-ups are not those with gout pain in the big toe but those whose gout originated in other joints (such as knee or elbow), according to study co-author Dr. Eric Matteson, rheumatology chair at the Mayo Clinic, and who is also featured in Gout Solutions.
Another Mayo Clinic study, of advanced osteoarthritis patients, found uric acid crystals in their joints similar to those found in gout patients. These patients did not show symptoms of gout, and the May Clinic plans “more research to determine whether the crystals contribute to the severity of osteoarthritis or are simply a by-product of it, according to Dr. Matteson.
Vitamin C Does NOT Help Gout?
But…wasn’t it common knowledge that it does? Not according to new research published by the American College of Rheumatology, which research concluded that vitamin C did not lower the blood level of uric acid in gout patients to a clinically significant degree. According to professor Lisa Stamp of the University of Otago in Christchurch, New Zealand, “Though vitamin C may reduce risk of developing gout, our data does not support using Vitamin C as a therapy to lower uric acid levels in patients with established gout.” For more details, see: Vitamin C does not alleviate gout as previously thought.
Coffee is Good Gout Medicine?
According to the Mayo Clinic, studies have found an association between coffee drinking — both regular and decaffeinated coffee — and lower uric acid levels, though no study has demonstrated how or why coffee may have such an effect. So It’s Official; Coffee IS Good for You!
Genetic Mutation Cause of Gout Revealed
As mentioned in my Web page on gout, “People need to understand that gout is a genetic disease,” according to Dr. Theodore Fields, Professor of Clinical Medicine at Weill Cornell Medical College in New York. “Ninety percent of people with gout have a genetic defect which causes them to be unable to put enough uric acid into the urine, so it builds up in the body. Ten percent have a genetic defect that causes them to make too much uric acid, with the same end effect.”
Just published (4/4/13) research from Johns Hopkins, http://newswise.com/articles/view/601342/ … actually reveals the genetic mutation behind the inability to clear uric acid from the blood stream.
By the way, the science wire service Newswise is another of those great resources for people looking for the latest medical news. And, of course, you can search their archive for research on your topic of interest.
Gout Misconceptions Challenged
Three misconceptions about gout were challenged in a recent article, “Challenged: Six Misconceptions About Gout and Arthritis,” in The Journal of Musculoskeletal Medicine. Those misconceptions are challenged below.
You should know, however, that this article is just one in a treasure trove of information offered by The Journal of Musculoskeletal Medicine on gout, plantar fasciitis and other topics to anyone who cares to use the resource. All you have to do is sign up – and it’s free – for access, and you can also opt to receive periodic emails highlighting articles on new research and publications.
As an example, here are the three misconception challenges from an article in the March 5 email that popped up on my email:
“Assumption #1. Gout does not occur in patients with rheumatoid arthritis.”
“In another one of those large longitudinal studies from the Mayo Clinic, during nearly 10,000 patient-years of followup among people with rheumatoid arthritis (RA), the 25-year cumulative incidence of gout diagnosed by clinical criteria was 5.3%, arising most commonly in the great toe. Monosodium urate crystals were documented in nearly half of these patients, all of whom were diagnosed with RA before gout developed. This is a lower rate of gout occurrence than in the general population, although the risk factors are similar: male gender, obesity, and older age.”
“In a survey of patients who reported having one gout attack within the previous year, backed up by medical records review, colchicine protected against gout attacks only if it had been taken consistently over the preceding 14 days. Intermittent and inconsistent use of colchicine, or NSAIDs however consistently used, were ineffective in preventing gout attacks. (However, this community-based study cannot exclude the possibility that certain formulations and/or doses of NSAIDs, used consistently, may be effective.)”
“Assumption #3. Rheumatologists and primary care physicians can achieve flare-free status for most patients with chronic gout by appropriately prescribing xanthane oxidase inhibitors.”
“One-third of gout patients considered “adequately controlled” by their physicians experienced two or more gout flares per year, according to a national survey of 125 U.S. rheumatologists and 124 primary care physicians by Dinesh Khanna and Puja Khanna of the University of Michigan. Only 26% of the patients were free of flares during the year under study, and fewer than half achieved serum urate levels below 6 mg/dL. (Are current treatment standards and options inadequate to control gout, as the researchers conclude, or are many physicians insufficiently vigilant?)”