Will New Gout Findings Get a Toehold?

Flare-ups most likely if condition starts in joints such as knee or elbow, researchers say

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- The big toe is not the biggest culprit in gout flare-ups, contrary to popular belief, a new study reports.

Researchers from the Mayo Clinic in Rochester, Minn., found that people with the highest risk of repeated cases of gout are those whose gout first appears in other joints, such as the knee or elbow, rather than in the joints of the big toe.

Gout is a painful form of arthritis caused by uric acid buildup in the body. Continuing to take medication is essential to prevent recurrences, the researchers said.

"Because patients often think that a gout flare-up means their medications are not working, they may stop medications like allopurinol. It is especially important for these patients to continue taking gout medication to prevent flare-ups," study co-author Dr. Eric Matteson, rheumatology chair, said in a Mayo news release.

The study was scheduled for presentation at the annual meeting of the European League Against Rheumatism, June 12 to 15, in Madrid.

Researchers followed 46 gout patients for about 13 years on average. Their first gout attack occurred at an average age of 66.

Mayo researchers presented other studies at the meeting. Among those findings:

Black American lupus patients with certain autoantibodies (anti-RNA-binding protein autoantibodies) have higher levels of interferon, a protein involved in inflammation. The finding may explain why black Americans have worse lupus than whites and could lead to improved treatments, the researchers say.Rheumatoid arthritis patients have greater changes in their systolic blood pressure (the top number of a blood pressure measurement) from one health care visit to another than people without the disease. That erratic blood pressure was linked to heart disease, which means that doctors need to closely manage heart disease risk in these patients.Another study may help explain why smoking doubles the risk of developing rheumatoid arthritis. In people with a genetic predisposition to a particular immune response, smoking triggers immune cells called dendritic cells, the researchers found. Unlike osteoarthritis, which is related to wear and tear, rheumatoid arthritis is an autoimmune disorder, meaning the body attacks its own cells.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

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