Paul Tassin  |  July 13, 2019

What Is Gout?

Many people have heard of gout, but not everyone realizes the malady is a type of inflammatory arthritis. Like all forms of arthritis, gout can be very painful, but usually affects only one joint at a time.

Most often, the small joint of the big toe on one foot becomes the target of a gout attack. Other commonly affected areas are the ankles, knees, wrists, fingers and elbows.

Even though there’s no cure for gout, the arthritis goes through cycles of remission during which the patient has no symptoms, followed by periods of flare-ups.

Gout is caused by an unusual buildup of uric acid crystals that settle in the joints. The uric acid crystals also may produce kidney stones. If the crystals block the kidney’s filtering tubules, the patient can suffer from kidney failure.

Common Symptoms and Causes of Gout

An acute gout attack usually lasts a few hours to a few days. In some rare instances, a gout attack will last for weeks. Some patients have noted that even the weight of a bed sheet touching the gout-affected area causes severe, intense pain.

Once someone experiences a gout attack, the attacks generally occur repeatedly over the rest of the patient’s lifetime. Someone unfamiliar with a gout attack might mistake it for an infection because the affected area will appear red, swollen, warm and tender to the touch.

When the body produces too much uric acid, the condition is known as hyperuricemia. When the excess acid crystals settle in the joints, a gout attack occurs. If your parents have gout, you have a 20 percent chance of having it, too.

In addition to heredity, other risk factors include:

  • Advanced age, which peaks at age 75
  • Being post-menopausal
  • Being obese
  • Being male
  • Drinking a moderate to heavy amount of alcohol
  • Eating or drinking foods high in fructose, a type of sugar
  • Eating a diet rich in purines, which include foods such as red meat, organ meat and some seafoods.
  • Having health problems such as diabetes, high blood pressure, congestive heart failure, metabolic syndrome or impaired kidney function

Gout Drug Linked to Increased Risk of Death

Gout medication Uloric (febuxostat) by Takeda was approved by the U.S. Food and Drug Administration (FDA) in 2009. At that time, Uloric was the first new gout medicine approved since allopurinol hit the market in 1966.

In early 2019, the FDA updated Uloric’s prescribing information by requiring a Boxed Warning, the agency’s most prominent warning, regarding a safety clinical trial that found an increased risk of heart-related death and death from all causes in Uloric users.

The FDA also said, “We are limiting the approved used of Uloric to certain patients who are not treated effectively or experience severe side effects with allopurinol.”

Serious Uloric side effects came to light when a whistleblower lawsuit was filed by a former Takeda safety consultant who alleged the drugmaker kept secret a variety of negative Uloric side effects in order to ensure the drug made it on the market before any competitors could.

Families of patients who have died while taking Uloric may be eligible to take legal action for wrongful death and other allegations.

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