Gout Drug May Also Help After Heart Attack, Study Finds

Content

• Younger Women Less Likely To Get Aggressive Treatment And More Likely To Die Due To Cardiogenic Shock Following A Heart Attack
• Use Our Arthritispower App To Manage Your Gout
• Chronic Gout
• Inflammatory Bowel Disease
• What Is The Difference Between Acute And Chronic Gout?
• How Are Gout And Pseudogout Treated?

We included randomized clinical trials that compared febuxostat to one or more control groups, reported adverse events including cardiovascular events, had a follow-up period of any length, and were published in English. We excluded reviews, cohort and cross-sectional studies, and case reports. Moreover, in our study we found a stronger relationship between gout and CVD after confounder correction was attained (adjusted OR 3.39, 95% CI 2.37–4.84; Table 2, model 2) compared to the literature (age-adjusted OR 2.70)11. A likely explanation is that gout in our study was always based on MSU crystal identification, while other studies accepted clinical criteria for the diagnosis of gout2,5–12. Misclassification resulting from using the clinical diagnosis of gout could lead to underestimation of the real effect between gout and CVD.

Younger Women Less Likely To Get Aggressive Treatment And More Likely To Die Due To Cardiogenic Shock Following A Heart Attack

Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins. Gout causes intense pain and swelling around one or more joints. Gout most commonly affects the joint at the base of the big toe.

In 2019, the National Psoriasis Foundation and American Academy of Dermatology published guidelines on the treatment of psoriasis with attention to comorbidities. The guidelines state the following health conditions as comorbidities of PsA. People living with PsA are at risk for the same comorbidities as psoriasis.

Use Our Arthritispower App To Manage Your Gout

Becker MA, Baraf HS, Yood RA, Dillon A, Vázquez-Mellado J, Ottery FD, Khanna D, Sundy JS. Long-term safety of pegloticase in chronic gout refractory to conventional treatment. So A, De Smedt T, Revaz S, Tschopp J. A pilot study of IL-1 inhibition by anakinra in acute gout. Manger B, Lell M, Wacker J, Schett G, Rech J. Detection of periarticular urate deposits with dual energy CT in patients with acute gouty arthritis. Owens D, Whelan B, McCarthy G. A survey of the management of gout in primary care.

Is gout a symptom of diabetes?

Articles On The Link Between Diabetes and Gout
If you have type 2 diabetes, your chances of getting gout are higher. And the same is true in reverse. Gout boosts your chance of diabetes. Gout is a kind of arthritis that causes sudden pain and swelling in your joints.

The key to preventing gout attacks is a healthy diet and lifestyle modifications, but many patients with gout also need a type of medication known as xanthine oxidase inhibitors to prevent the excess build-up of uric acid in the body that leads to gout. The two medications approved for the treatment of elevated uric acid levels in patients with gout are allopurinol, approved in 1966, and febuxostat, approved in 2009. Research links gout to an increased risk of several types of cardiovascular disease, including heart attack, heart failure, and atrial fibrillation, or an irregular heartbeat. A 2018 Arthritis Care & Research study, for example, found that adults 65 and older have at least a two-fold risk of heart attack compared with those without gout. In addition to the uric acid lowering therapy some other pharmacological measures can be helpful to reduce serum uric acid.

Chronic Gout

For example, pseudogout, caused by a different type of crystal , causes the same type of hot, red joint, and the same rapid acceleration of pain as does gout. Pseudogout can be distinguished by seeing calcium deposits within the joints on X-ray, which deposits in a different way than it does in gout. When fluid is examined from an inflamed joint in pseudogout, the specific causative crystal can be seen. It has been estimated that there may be as many as five million gout sufferers in the United States. Even more conservative estimates put this number at greater than two million .

Is gout a symptom of kidney disease?

Kidney disease can lead to gout
When you have kidney disease, your kidneys cannot filter out uric acid as well as they should. Too much uric acid building up in the body may cause gout. Most people with early stage kidney disease do not know they have it. Gout can be a warning sign of kidney disease.

Women are more likely to have atypical symptoms of a heart attack, such as fatigue, shortness of breath, jaw and back pain, and nausea. Researchers noted, though, that the drug does come with an increased risk of pneumonia, which appeared in 0.9 percent of colchicine patients. The pill also cut the odds of death from any cardiovascular event by 16 percent, halved the likelihood of patients being hospitalized for coronary bypass or stenting, and reduced the risk of stroke by 74 percent. Data were collected on 5,713 adults aged 65.5 years or older in the REasons for Geographic And Racial Differences in Stroke cohort study.

Gout And Cardiovascular Risks Similar

More evidence seems to be needed to support the considerations about consistency, analogy, and coherence. The associations between hyperuricemia and cardiovascular diseases have not been described to be as strong as associations of cardiovascular disease with smoking, hyperlipidemia, diabetes, and hypertension . The association between hyperuricemia and cardiovascular diseases is not specific, but this one is probably the most outdated of Hill's considerations. Multiple population-based human studies have established a strong association between increasing levels of serum urate and subsequent development of hypertension (for a complete list, see ). This association has even been reported in subpopulations of individuals, such as those with rheumatoid arthritis in a recent cross-sectional prevalence study . The degree to which epidemiological studies can control for potential confounders is variable, but most studies would examine the role of diuretics, dietary factors, and alcohol intake in the reported associations.

Uric acid crystals can be thought of like matches, which can sit quietly or can be ignited. Crystals can be present for years in the cartilage, or even in the joint fluid, without causing inflammation. Then, at some point, due to increasing number of crystals or other inciting factor, the matches are “struck” and the inflammation begins. This analogy is important both for conceptualizing the uric acid crystals in the joint and for understanding the various types of gout treatment , some of which attack the inflammation and some of which remove the uric acid crystals . Teng GG, Ang LW, Saag KG, Yu MC, Yuan JM, Koh WP. Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study.

For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase (Krystexxa®), since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus. My personal feeling is that herbal and other alternative/complementary approaches may well ultimately be proven to improve inflammation in gout, but lowering uric acid is the key to success in gout management. Diet has been discussed in more detail above, and gout is clearly one of the rheumatic diseases where diet is unequivocally important.

You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own. People with gout have a twofold higher risk of obstructive sleep apnea, a disorder characterized by frequent seconds-to-minutes-long pauses in breathing during sleep, according to a 2018 Journal of Clinical Sleep Medicine study. Understanding your vulnerability to gout’s linked conditions means you can make lifestyle changes, such as adopting a healthier diet, moving more, and losing weight, that lower risks and improve symptoms. At the same time, your doctor can watch for developing problems and intervene with treatments that limit damage. Having a chronic disease like arthritis affects many aspects of daily living and can cause stress.