Presented by Theodore Fields, MD, professor of clinical medicine at Weill Cornell Medical College and attending rheumatologist at the Hospital for Special Surgery in New York City
Gout is a common form of inflammatory arthritis caused by excess uric acid deposits, especially in the joints and the tissues around the joints. Gout tends to affect more men than women. Unfortunately, gout is commonly misunderstood. Compared with other rheumatic diseases, gout is very responsive to treatment; a “cure” is possible for the vast majority of people who stay on medication. Yet, gout is one of the worst-managed rheumatic conditions long term. Why do people often think that gout flares cannot be prevented? Why do they believe that diet changes alone will control gout?
In this webinar, Dr. Fields covers a range of issues around gout, including what causes this chronic disease, the role that uric acid plays in gout, the many facts and misconceptions about the role of diet and medication in gout, and how to work with your doctor for optimal long-term gout control.
Fast Facts from the Webinar
1. Without treatment, gout flares will worsen and become more frequent over time
Gout is considered a periodic illness. When first diagnosed, patients get flares (attacks) followed by quiet periods with no pain in what are referred to as “intercritical periods.” This often makes people wrongly assume that their gout is gone once an attack has subsided. If left uncontrolled, however, gout attacks will almost always increase in number. The aim is to control gout before the number of attacks increases and the disease becomes more advanced. This is why gout is considered both a chronic and a progressive disease.
2. Monitoring uric acid levels is important in gout control
A key goal in controlling gout is to lower a patient’s blood uric acid (urate) level to below 6.0 mg/dL.
3. Diet alone cannot manage gout for the majority of patients
While diet can help control gout by mildly lowering the amount of uric acid in the blood and helping to decrease flares, diet alone cannot adequately reduce uric acid in with the great majority of people with gout. Research has shown that hereditary factors remain a more important cause of gout than diet. While hydration is important, and dairy products may mildly lower urate level, effect of changes in diet are generally not sufficient to stop flares. Cherry juice, for example, has only a small effect on uric acid level in a study of people without gout. Interestingly, a small study of patients with gout actually showed no effect of cherry juice. However, an array of safe and readily available medications are highly effective in controlling gout.
4. Gout is best managed with a combination of approaches
This includes monitoring blood uric acid levels with your doctor, making sure to take medication and following up with labs even if you feel good, and taking a “bridge” medication (e.g., colchicine) during the first six months that you are taking a medication, such as allopurinol, that lowers your urate level. Watching your diet also helps, especially early in your treatment, but is generally not sufficient, by itself, to achieve long term remission of gout.
Get Involved in Arthritis Research
If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.
This webinar was produced with the Autoimmune and Systemic Inflammatory Syndromes Collaborative Research Group (ASIS CRG). As part of the National Patient-Centered Clinical Research Network, this research group collaborates with stakeholders including patients, caregivers, advocacy groups, providers, and funders early on to move research forward more quickly and more efficiently. Learn more about our work here.