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From Medscape Rheumatology (free registration required) Expert Interview
Latest Advances in Treatment for Gout: An Expert Interview With Kenneth G. Saag, MD
Editor's Note: The evidence from national and international studies shows that the incidence and severity of gout are increasing and start at an earlier age. Increasing evidence shows that changes in dietary habits can lead to the development of insulin resistance syndrome to which hyperuricemia, and thus gout, relate. Hyperuricemia results from poor renal clearance of uric acid, and low-calorie diets result in improvement of the renal clearance of uric acid, consequently leading to a reduction in serum uric acid levels. Dietary modifications can correct insulin resistance syndrome and thus reduce uricemia by its effect on increasing the renal clearance of urate. Although in most cases gout can be managed through dietary modifications, there are some colloquially referred to as "difficult gout," which can be recalcitrant to treatment.
Traditional pharmacologic treatments include colchicines, anti-inflammatory drugs, or steroids; however, there are serious side effects, particularly at high doses. As the interest in gout continues to grow, there is increasing understanding of its pathophysiology, with new research emerging for improved treatment options.
In this expert interview conducted by Helen Fosam, PhD, Medscape Rheumatology, Kenneth G. Saag, MD, comments on some of the more recent advances presented at the 2005 American College of Rheumatology (ACR) meeting for the treatment of gout. Dr. Saag is Associate Professor, Department of Medicine, Division of Clinical Immunology and Rheumatology at The University of Alabama, Birmingham.