Gout affects five million Americans. It is a painful chronic type of arthritis caused by an over production or under excretion of uric acid in the blood. The excess uric acid forms crystals that surrounds and affects the joints particularly the big toe joint. The treatment of gout includes short term care to stop the excruciating pain, swelling, tenderness and inflammation in the joint and long term management to prevent future gout attacks.
On November 14, 2005, Dr. William Shiel reported to the annual scientific meeting of the American College of Rheumatology that, “researchers from the University of Oklahoma, University of Pennsylvania and University of Chicago report two very interesting papers on a new product of treatment called febuxostat as a generic name that is useful for the long-term management of gout. Other new treatments approaches include better diagnostic technique and keeping the serum level below 6.0 mg/dl.”
Febuxostat is a new drug approved by the Food and Drug Administration for the long term treatment in reducing elevated serum uric acid levels in patients with gout. It will be available in the U.S. under the name Uloric in oral tablets of 40mgs and 80mgs dosages. Alan MacKenzie, President of Takeda North American Division states, “Febuxostat is the first new gout treatment in 40 years.”
A Duke University Study
Peglotisace is a natural enzyme found in mammals except the great apes and humans. It is said that: “humans do not express this enzyme owing to a mutation of the uricase gene during evolution.” This enzyme is under a phase two study at Duke University Medical Center. Peglotisace is proposed as a treatment for gout because studies show that when Peglotisace is given intravenously it brings uric acid to a normal level within six hours.
New Diagnostic Approach
A new and interesting diagnostic approach was studied by researchers at Cooper University Hospital in New Jersey. This involved the use of ultrasonography or the use of the ultrasound to detect uric acid build up in the inflamed joints of the feet of patients suffering with gout. Further studies will be done to determine if this will be a practical way to diagnose gout in the future.
The Food and Drug Administration (FDA) approved labeling for Febuxostat warns against patients who have elevated serum uric acid levels taking Febuxostat without a diagnosis of gout. Side effects of Febuxostat are liver function abnormalities, nausea, rashes and joint pain. The labeling on Febuxostat recommends that “Febuxostat users undergo periodic testing of liver function testing and monitoring for cardiovascular events.” In the future doctors will be more aggressive about lowering the uric acid level even below 6.0 mgs/dl.