On Saturday April 14th, Dr. Clement Michet joined us to discuss gout. Gout is a form of arthritis which generally affects men, however women become increasingly susceptible following menopause. We discussed risk factors, treatment, drugs and prevention.
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Having my second attack of pseudogout in less than 4 weeks. Used prednisone first round, now on colcrys, cheap drug must not have done the job, super expensive one is not doing much either. Can we expect any new treatments?
Dr. Michet says “There are new treatments for pseudo gout under development, but we anticipate that they will be very expensive, unfortunately not any bargain compared to prednisone.”
Why do Doctors prescribe Allopurinaol if it does not stop gout from Happening ????
Allopurinol is prescribed to decrease the production of uric acid, therefore decreasin the concentration of uric acid in the blood and urine. It is a long term management to help prevent flare-ups.
Dr. Michet says “This is a common concern voiced by patients. By the time a person has their first gout attack, there is considerable deposition of uric acid in the joints. When allopurinol is started, the blood uric acid level must be reduced to 6 mg% or lower, to allow these deposits to dissolve. This reversal of the gouty process may take months and it it no uncommon to see continued gout attacks after allopurinol has been started. Eventually the gout will stop if allopurinol is taken daily and at a dose sufficient to get the blood level down to the target level.”
Unfortunately, I missed the program, but will hopefully catch the archive as soon as it is posted. My husband suffers from gout and the attacks have been more frequent recently. He actually had one this morning, which is why I am so disappointed to have missed the program. He is allergic to NSAIDs and cannot take most of the medicine prescribed for gout. Previous doctors have prescribed narcotic pain meds and Prednisone for the inflammation (which I hate for him to take due to the long term affects. He has taken it quite often every since he was a child due to severe asthma.). What are somethings we can do to help treat and prevent gout attacks in the future? What references do you recommend?
Dr. Michet says “Recurrent gout requires daily administration of allopurinol to lower the uric acid level to below the concentration where it can crystallize in joints. This can be accomplished by gradually increased doses of allopurinol. If your husband is allergic to allopurinol, then the new drug Uloric would be a good choice. Unless the uric acid level is controlled long term, her will continue to have attacks. You are very corrected that long term prednisone treatment is not an ideal management approach.”