GoutPal Interactive

Though most gout patients – or at least the ones who read GoutPal.com – understand the importance of lowering uric acid, many are concerned about medication side effects.

To put this into context, the side-effects of NOT lowering uric acid are extensive bone, cartilage, and tendon damage for gout sufferers. This is permanent damage caused by urate crystals, but so slow that you do not notice until it is too late. Another side-effect of high uric acid in the blood is an increased risk of kidney stones. These can cause permanent kidney damage, and they are extremely painful. So, before you dismiss urate lowering therapy for fear of the (often low) risk of side effects, consider carefully the (almost certain) risks of doing nothing.

I’ve written about allopurinol side effects before, but now that we have a new uric acid lowering drug, febuxostat, gout patients are wondering if this has fewer effects.

A clear side-by-side comparison is beyond the scope of this article. There are several comparative studies, but none, as far as I am aware, are a strict comparison of doses at similar uric acid levels.

Febuxostat launched recently in the US under the brand Uloric. Previously, it was launched in Europe under the brand Adenuric. Earlier this month, the European Public Assessment Report for Adenuric was updated, which includes summaries of side effects from trials of febuxostat for gout patients.

Febuxostat Side Effects

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The “shocking” statistics reveal that:

• 65% of adults admitted to being “not at all knowledgeable” about gout.
• Over 70% did not know that gout is a form of arthritis.
• 83% said they have not had their uric acid levels checked in the last five years, or weren’t sure if they had.
• 35% of gout sufferers said they have not had their uric acid levels checked in the last five years, or weren’t sure if they had.
• 49% of adults were not aware of the potential crippling effects of gout, such as needing to use a cane or walker, or having to stop working because of limited mobility.

But where did this data come from, and why does it matter?

It matters, because raising gout awareness might push more people into seeking early treatment. By controlling uric acid at the earliest opportunity, people can avoid or reduce the crippling effects of gout.

Such awareness would be good if it encouraged people to get wise advice on managing uric acid and safe alternatives for pain relief until uric acid was correctly controlled. It would be wonderful if the general practice doctor could be relied on for simple proven therapy that will allow gout patients to keep uric acid below 6mg/dL and live a pain free life.

We should praise the Gout & Uric Acid Education Society for pushing confirmed gout sufferers to seek treatment, and unconfirmed gout patients to seek diagnosis.

Unfortunately, experience (and abundant research) tells us that the doctor we rush to has, in many cases, little more knowledge about gout than we do.

Except, of course, they will have been primed by the manufacturers of recently released Uloric (febuxostat) and soon to be released Krystexxa (pegloticase / PEG-uricase / Puricase). They will know all about the new wonder drugs from Takeda and Savient – the very same pharmaceutical companies who sponsor the Gout & Uric Acid Education Society.

All gout sufferers should be happy to have this choice. Allopurinol intolerant gout patients must be euphoric.

I know many GoutPal visitors suffer reactions to allopurinol that make it impossible, or uncomfortable to maintain crucial uric acid lowering treatment. These are a minority of allopurinol users as most people can take allopurinol without problems. Patients with kidney problems are common in allopurinol-intolerant groups.

If you have this intolerance, please see your doctor today and discuss Uloric for your gout. If you live outside the US, febuxostat may well be approved in your country, but it might be sold as Adenuric.