Help is on the way for longtime gout sufferers. The first new gout drug in more than 40 years, called Uloric, has been approved by the FDA for treating chronic elevated levels of uric acid in gout patients. Uloric is manufactured by Takeda Pharmaceuticals and is taken orally once a day. Gout is a sudden attack of pain in the joints, especially in the feet and legs, that occurs when uric acid builds up. Uric acid is a chemical that is formed when the body breaks down substances known as purines that often are found in foods like liver, anchovies, mackerel, dried beans and peas. Beer and wine also can contain purines.

Usually, uric acid dissolves in the blood, is carried to the kidneys and leaves the body in urine. But a buildup of uric acid can result in gout.

Symptoms develop suddenly and usually involve only one or a few joints. The big toe, knee or ankle joints are most often affected.

“This new drug works by blocking the protein from breaking down and becoming uric acid, which is the cause of gout,” said Dr. Richard Lesser, a Howell-based podiatrist who is a member of the Kimball Medical Center staff in Lakewood. “Over time, you start seeing a reduction in the uric acid count.”

The excrucating pain from gout frequently starts during the night. The joint appears
infected, with signs of warmth, redness and tenderness.

“My patients tell me they go to bed and everything is fine,” Lesser said. “Then, all of a sudden, in the middle of the night, they wake up in severe pain. Even the bed sheets rubbing against their big toe causes intense pain. They call me first thing in the morning and usually have no idea what is going on.”

The attacks of painful joints may go away in several days, but may return from time to time. Additional attacks usually last longer.

Some people may progress to chronic gouty arthritis, while others may have no further attacks.

Prior to the release of Uloric, doctors prescribed colchicine or allopurinol to help prevent future attacks. But the results were mixed.

Doctors say they are seeing more cases of gout, especially in men.

“That is because the risk factors are increasing,” Lesser said. “There is more obesity, more medication that might trigger a gout attack. You also have an increase of diabetics and they are at risk for gout. Diet is very important in controlling gout.”

Sometimes, a diet low in purines is prescribed.

“One of the first things I ask my patients is what they ate for dinner,” Lesser said.
“Often, I hear things like liver, scallops, shellfish and red meat. They all may trigger
gout.” APP