“Gout hadn’t changed for decades,” recalls Dr. William P. Jennings, medical director at Radiant Research, San Antonio, who has been practicing internal medicine since 1979.  “The diagnosis and treatment had been standard, but then in the last three years, there have been a lot of new developments.”

Eat wisely

Dr. Yuqing Zhang, professor of medicine and public health at Boston University’s School of Medicine, has studied the triggers of gout extensively. It has long been known that diet plays a role in gout management, but a recent study published in Annals of the Rheumatic Diseases suggests certain foods are associated with a fivefold greater risk of an immediate flare-up. 

“Patients with a history of gout have to pay attention to what they eat and drink,” he urges.  “Many gout patients don’t know this. Even some physicians don’t know. We have seen a lot of mismanagement of gout.”

Moreover, some patients may understand the risks of eating certain foods but do it anyway, Dr. Zhang laments. 

A need for better treatment

Two factors have been driving increased interest in gout in recent years: the number of people suffering from it has been on the rise, and many health care professionals believe we need better treatment.  “We see the writing on the wall.  This is going to be more of a problem, and we want to see if a drug could do better than what’s currently available,” says Ronald Ruhaak, research manager at East-West Medical Research Institute in Honolulu.

“The current treatments are not ideal,” agrees Dr. David Fitz-Patrick, medical director and president of East-West Medical Research Institute.   “The goal is to get patients’ uric acid levels below six.  Of the patients taking allopurinol and febuxostat, only half achieve this.  The other half do not, and some still experience attacks.”

Through his work at the clinic, Ruhaak has met many gout sufferers and witnessed their pain firsthand.  “They say it is excruciating.  They describe it as glass shards inside their big toe area.  Everyone tells me they can’t even put a sheet on it.  Some even say when their spouse walks by, the movement of the air is enough to make it hurt!  It is one of the worst pains out there.”

Dr. Fitz-Patrick urges patients to seek professional care to determine if they are a candidate for treatment with a drug, and to follow a low-purine diet.  “If they do not, they may have reoccurring attacks that are disabling and inconvenient.  They could also cause damage to the joints and be predisposed to kidney stones.”