New research shows that use of poor footwear is common among patients with gout. According to the study published in Arthritis Care & Research, a peer-reviewed journal of the American College of Rheumatology (ACR), gout patients who make poor footwear choices experienced higher foot-related pain, impairment and disability. Gout patients also reported that comfort, fit, support and cost were the most important factors for selecting footwear. Gout is a type of inflammatory arthritis caused by the crystallization of uric acid within the joints and other tissues. Those with gout experience severe pain and swelling, with the majority of cases affecting the feet. A study published last month in the ACR journal, Arthritis & Rheumatism, shows that doctor-diagnosed gout has risen over the past twenty years and now affects 8.
According to a study in the August 17 issue of JAMA, patients with severe, chronic gout who took pegloticase for 6 months as an alternative to conventional gout treatment that some patients may not respond to, showed greater improvements of uric acid levels as well as physical function and quality of life. According to background information in the article, a lowering treatment for long-term urate (a salt derived from uric acid) aims to maintain concentrations of uric acid (UA) below a certain level; however, it is normal for UA levels to raise above a recommended goal urate scale during oral urate-lowering therapy among 5 to 6 million gout sufferers in the United States. Even though oral urate-lowering medications available can achieve a target UA in most patients, it proves ineffective in approximately 3 percent of patients because of refractoriness (resistant to treatment), contraindication, or intolerance.
Injections of pegloticase, a modified porcine enzyme, can produce significant and sustained clinical improvements in 2 out of 5 patients with chronic gout that is resistant to conventional therapies, researchers report in the August 17, 2011, issue of JAMA. In two controlled clinical trials, pegloticase rapidly lowered high levels of uric acid, the biochemical abnormality in gout, and kept it in the normal range for six months or more in 42 percent of patients receiving the drug every two weeks. Forty percent of patients had complete resolution of at least one of the painful swollen joint nodules, known as tophi, a hallmark of severe gout. Injections of pegloticase, a modified porcine enzyme, can produce significant and sustained clinical improvements in 2 out of 5 patients with chronic gout that is resistant to conventional therapies, researchers report in the August 17, 2011, issue of JAMA.
Individuals with severe, chronic gout who have not responded to conventional treatment may benefit from six-months' worth of pegloticase treatment. Researchers from Duke University Medical Center, Durham, N.C., reported in JAMA (Journal of the American Medical Association) that individuals experienced better levels of uric acid as well as physical function, quality of life, and less pain. The aim of long-term urate reduction therapy among individuals with gout is to keep uric acid concentrations below a certain level. However, uric acid levels commonly exceed the recommended range during this therapy in a significant number of patients, the authors explained. Oral urate-lowering medications generally work for most patients with gout. Unfortunately, for about 3% of them this is not possible, either because they are resistant to treatment, intolerant of the medication, or cannot take it (contraindication).
Increase In Obesity And Hypertension Are Likely Contributors To The Increase In Gout Prevalence In US Over Last 2 Decades
A new study shows the prevalence of gout in the U.S. has risen over the last twenty years and now affects 8.3 million (4%) Americans. Prevalence of increased uric acid levels (hyperuricemia) also rose, affecting 43.3 million (21%) adults in the U.S. Greater frequency of obesity and hypertension may be associated with the jump in prevalence rates according to the findings now available in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR). Gout, an inflammatory arthritis triggered by crystallization of uric acid within the joints, causes severe pain and swelling. Medical evidence suggests that gout is strongly associated with metabolic syndrome - a group of health conditions characterized by central obesity, insulin resistance, high blood pressure and blood lipid issues - and may lead to heart attack, diabetes and premature death.