Despite hopes that rilonacept might provide a better alternative to NSAIDs or colchicines for gout pain, it does not provide significant relief either on its own or as an add-on therapy to indomethacin.
Does this evidence from recent research overturn some generally accepted principles about gout, rheumatoid arthritis, reactive arthritis, and osteoarthritis? Most of these studies were undertaken in order to test ideas that were described as common wisdom in rheumatology.
Dual-energy CT scans of ligaments and bones in patients with tophaceous gout showed patterns of monosodium urate crystal deposition suggestive of a role for biomechanical strain. The Achilles tendon was the most commonly involved site.
Used for gout for centuries, colchicine is known to be peculiarly toxic at high doses. A new understanding of its potential for poisoning, deliberate or otherwise, merits attention to its often-underestimated risks.
Among the revelations about gout treatment at this year’s meeting: Confusion among physicians about the definition of “control,” misunderstandings among gout patients about their own disease, and new drug options.
Beyond causing gout, uric acid appears to be on the verge of stepping into a far broader role. Collectively, numerous clinical and animal studies portray it as the central villain in the mystery that links hypertension, kidney failure, and diabetes.