EDU: Gout - New Treatment and Diagnosis (Nov 2005... with audio)

[Guest guest]

Shiel, M.D., FACP, FACR, Editor of MedicineNet's Arthritis Overview,

Offers Perspectives Of Interest On Topics From 2005 Annual Scientific Meeting of

The American College of Rheumatology (held November 12-17, 2005)

Listen now to installment #1 (transcript) on Gout - From Dr. Shiel who

is at the Arthritis Conference in San Diego, CA (MP3 4:16min 1.96MB)

Arthritis Conference - Installment #1 (transcript) on Gout

Gout and Gouty Arthritis – New Treatment and Diagnosis

More News in the Field of Gout Treatment

Gout Diagnosis

Gout and Gouty Arthritis – New Treatment and Diagnosis

Monday, November 14 - This is Dr. Shiel reporting from San Diego for

the 2005 annual scientific meeting of the American College of Rheumatology --

the national arthritis meeting. Today I’d like to discuss several very

interesting papers related to gout that I believe are very important for our

viewers. They represent new information both in diagnosis and treatment of gout.

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. Febuxostat was shown to reduce the incidence of gouty

attacks and gouty arthritis more effectively than the long-term gold standard

treatment for gouty arthritis called allopurinol. Febuxostat was also shown by

the same research groups to reduce the size of the clumps of uric acid called

tophus or tophi (plural) which are annoying lumps that occur in the skin of

patients with chronic gout. The tophus size in these patients was reduced

overtime very effectively with the treatment of a febuxostat.

More News in the Field of Gout Treatment

It was shown by researchers that treating the uric acid level very

aggressively -- even below previous standards (serum uric acid levels well below

6.0) much more effectively control gouty arthritis then simply lowering the uric

acid level to lower ranges of normal. I think what we are going to see doctors

doing in the future is aggressively treating the serum uric acid as an integral

part of the treatment of gout.

There is also a new medication that's being proposed as a treatment for gouty

tophi -- the uric acid lumps of accumulation that can occur in the skin in

patients with gout. In this particular treatment it is given intravenously and

would be for patients who have resisted treatment responses to other drugs. This

treatment is called uricase. Uricase is an enzyme that in mammals, other than

the great apes and in humans, that exists naturally. This enzyme degrades uric

acid for these mammals since humans do not have it. The treatment with uricase

was proposed as a possible treatment for gout. In fact when given intravenously,

it was shown by these researchers to significantly reduce the size of the tophi.

So I think we are going to see this product -- uricase undergo further scrutiny

of medical research to determine whether or not it might be an applicable

treatment for gouty tophi.

Gout Diagnosis

In the area of diagnosis of gout, a new imaging technique was studied by

researchers at University Hospital in New Jersey. It demonstrates that

using ultrasonography or ultrasound method (much like what a mother uses when

she's happily having a look at her baby in her womb), that this technique can be

used to look at the feet in patients who have inflamed joints and actually

detect the accumulation of uric acid over the inflamed joints of the classic

gouty foot. It remains to be seen whether this will be a practical method of

determining whether a patient has gout in the future, but this is an exciting

potential new avenue of diagnosis.

Go to Arthritis Center for more information.

(Beautiful Southern Oregon, USA)

We may not be able to change the direction of the wind, but we can adjust our

sails.

May you have enough happiness to make you kind, enough trials to make you

strong, enough sorrow to keep you human, enough hope to make you happy.

---------------------------------

Yahoo! for Good - Make a difference this year.