the prevalence of gout increases in relation to inadequate dietary habits and the increase in diseases associated.
XLI Congress national of the society Spanish of Nephrology.
-the disease affects 1% of the adult population. Dietary habits, obesity and the presence of other diseases increase the risk.
– has just been adopted in Spain a new treatment for gout, which was not the case for 40 years.
Seville, 2011-October The prevalence of gout is growing in the surrounding countries, due to factors such as unhealthy eating habits and the emergence of other diseases associated with greater longevity of the population. It is one of the conclusions of the General Committee advances in the treatment of gout in patients with renal failure within the XLI National Congress of the Spanish society of Nephrology. This rheumatic disease, which is attending with pain and swelling in the joints, affects about 1% of the adult population, and may reach 6% in men older than 70 years, according to a recent study carried out in United States and published in the journal Arthritis and Rheumatism (1).
Gout is one of the most ancient diseases of which record and its prevalence has grown over the last decade (2), due to lack of exercise, poor diet, the growth of obesity and a sedentary lifestyle, as well as the excessive intake of alcohol ”, according to Dr. José Luño, head of the service of Nephrology the Hospital Gregorio Marañón in Madrid, moderator of the General Committee. Gout usually appears after 35 years, but bad dietary habits observed in young people, as it is happening in Western countries, increase the risk of infected ”, adds Dr. Fernando Pérez of the Rheumatology service of the Hospital de Cruces, in Barakaldo. Also influence its increase in the ageing of the population and the use of diuretic medications that raise the levels of uric acid.
Gout is an inflammatory reaction sudden and intense in the toe of the foot, although it can also occur in the rest of the foot, ankle, knee and less frequently the upper limbs, explains Dr. Pérez. It is caused by a high concentration of urato, which originates in the body to decompose purine, a compound of the nucleoproteins. Foods that can increase uric acid are, in general, all rich in proteins, especially red meat and viscera, but also vegetables such as asparagus, peas, tomatoes, spinach; and legumes such as lentils, for its high content in purine ”, explains Dr. Marian Goicoechea, of the service of Nephrology of Hospital Gregorio Marañón in Madrid.
The urato is dissolved in the blood and is eliminated through the urine and feces. When very high are uric acid levels (hyperuricemia) for so long in time, either by an increase in their production or decreased in the excrección, it settles in the form of crystals of monosodium urato joints and gout attacks occur. After the first crisis of gout, the majority of patients shall suffer other crises within a year (3).
Gout long-term complications include injury to the bones and joints and the appearance of lumps in the skin and joints, called tophi. Hyperuricemia is also associated with increased risk of kidney stones.
first step in 40 years
during the Congress the results of the first treatment occur in 40 years (4) for chronic hyperuricemia in gout, which has just been adopted in Spain, febuxostat. This drug is indicated for the treatment of chronic hyperuricemia in situations in which has already occurred urato Depot, including symptoms, or the presence of tophi or gouty arthritis (5). Also demonstrated in various studies that it is capable of reducing and maintaining levels of uricemia below 6.0 mg/dl in a high percentage of patients (6.7), which is the target set by the EULAR (European League against rheumatism) (8). The sustained reduction of the levels of serum urato is associated to an almost complete elimination of gotosas crises, as well as a high rate of reduction of tophi (9).
Other contributions of this treatment is their safety, according to Dr. Luño: is a very effective, well tolerated drug that in addition to reducing the levels of uric acid may have positive effects on patients with kidney failure. In fact in a recent study that we led with Dr. Goicoechea and recently published in the journal of the American Society of Nephrology, intervention to reduce levels of uric acid in patients with chronic renal is associated with less progression of renal disease ”.
Referencia:
(1) Zhu, and Pandya BJ, Choi HK: Prevalence of gout and hyperuricemia in the U.S. general population. Arthritis Rheum. 2011 Jul 28. DOI: 10.1002/art.30520
(2) Richette p., Bardin T. Gout.Lancet 2010; 375: 318-328
(3) McGill NW.Gout and other crystal-associated arthropathies. Baillieres Best Pract Res Clin Rheumatol. 2000 Sep; 14 (3): 445-60
(4) M. Hu, Tomlinson B. Febuxostat in the management of chronic gout and hyperuricemia: a review. Therapeutics and Clinical Risk Management 2008; 4 (6): 1209-1220
(5) technical specifications of Adenuric ®
(6) MA, Schumacher HR Jr, Wortmann RL, et Becker to the. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med. 2005 Dec 8; 353 (23): 2450-61.
(7) Schumacher HR Jr, Becker MA, Wortmann RL, et to the. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum. 2008 Nov 15; 59 (11): 1540-8.
(8) Zhang W, Doherty M, Bardin T, et to the. EULAR evidence based recommendations for gout. Part II: Management. Report of task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006 Oct; 65 (10): 1312-24
(9) Schumacher HR Jr, Becker MA, Lloyd E., et to the. Febuxostat in the treatment of gout: 5-yr findings of FOCUS the efficacy and safety study. Rheumatology (Oxford). 2009 Feb; 48 (2): 188-94.
