One arthritis disease is leading to more hospitalizations and the other is causing fewer… next
Costs For Gout And Rheumatoid Arthritis
Reported in ET Health World …While hospitalizations related to rheumatoid arthritis have dropped considerably over the past two decades, hospitalizations primarily associated with gout have increased dramatically. These results of a study described in a research letter in JAMA reflect improved management of rheumatoid arthritis patients and both an increased prevalence and persistent suboptimal care of gout.
Comment: I’m not surprised. While getting RA patients into remission is easier, identifying and treating gout patients is getting harder. Much of that could be attributed to the obesity epidemic.
An over the counter preparation that could be life-threatening… next
FDA warns OTC antacids with aspirin can cause stomach or intestinal bleeding
Lydia Wheeler writing in The Hill reported that the Food and Drug Administration “is warning consumers to beware of over-the-counter drugs that contain both an antacid and aspirin.” According to the agency, these products “can cause stomach or intestinal bleeding.” Although rare, the FDA says it has identified eight cases of serious bleeding since 2009.
Comment: Not a big surprise here. In the old days when we used high doses of aspirin, people would get bleeding ulcers frequently.
Uric acid lowering therapy is important for patients with symptomatic gout. However, for certain groups there is a risk of treatment… next
HLA-B*5801 Testing Needed In Asians And Blacks With Gout
Dr. Jack Cush in Rheum Now reported on a study by Choi and colleagues who analyzed US hospitalizations (2009–2013) to assess the frequency and racial distribution of patients hospitalized with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) related to the use of urate-lowering (ULT) therapy (predominantly allopurinol). They found 606 hospitalizations while receiving ULT. There was an overrepresentation of Asians (27%) and Blacks (26%), and an underrepresentation of Whites (29%) and Hispanics (% too low to report).
These SJS/TEN events were 12 time more frequent in Asians, and 5 times more frequent in Blacks when compared to Whites (reference group).
The HLA-B*5801 allele has been strongly linked with the allopurinol hypersensitivity syndrome and has been found in higher frequency in certain populations, especially Koreans, Japanese, Thai and Han Chinese – and in some Europeans. This study demonstrates the potential use of HLA-B*5801 in U.S. Asians and Blacks.
Comment: Really important info to know when treating certain racial groups with gout.
Diet and gout… the proof is in the … whatever
DASH diet crushes gout risk
Dr. Jack Cush writing in Rheum Now reported on a study by Choi et al who examined the benefits of the DASH diet. The DASH diet is commonly employed as a dietary means of controlling hypertension. Like the Prudent diet, the DASH diet has no or low animal protein, but plenty of fruits, vegetables, and low fat dairy products. They compared the incidence of gout in those adhering to either a DASH diet or Western diet and used dietary “scores” to indicate the degree of adherence to either.
They enrolled 78906 women from Nurses Health Study beginning in 1984. With 22 years of follow-up, there were 778 incident gout cases. Those patients on the DASH diet had 33-40% lower risk of developing gout. Conversely, the Western Diet had a 37-68% higher risk.
Gout… when is the right time to start uric acid lowering treatment?
Old gout treatment model doesn’t hold up
M. Alexander Otto writing in Rheumatology News reported the old dictum of not starting uric acid lowering therapy during an acute attack is wrong. Dr. Brian Mandell reporting on a study from the Cleveland Clinic demonstrated their findings that showed that patients who were started on uric acid lowering therapy id the same whether the treatment was started during an attack or not.