Trending Clinical Topic of the Week (October 13-19): Gout
New treatment information, insight into risk factors, and news about potentially serious comorbidities helped increase the popularity of this week's top search term. In September, results of a new study revealed that canakinumab, an interleukin (IL)-1β blocker, significantly reduced the risk for gout attacks. However, it did not alter serum uric acid levels. Several other studies have demonstrated a benefit in blocking IL-1β during acute gout attacks, but this was the first such study to indicate a role in prevention. Most notably, this drug may be useful for patients who did not benefit from other therapies.
A separate study that examined allopurinol found that use of the drug to manage gout may also protect against chronic kidney disease (CKD). Because CKD affects 20% of people with gout, compared with only 5% of individuals without, this finding may be particularly helpful. The American College of Radiology has suggested that patients with advanced kidney disease and gout begin treatment with low starting doses, as allopurinol hypersensitivity syndrome that affects renal function is a concern.
In terms of prevention, a new study suggests that the assumption that gout is mainly caused by diet may not be accurate. A study of more than 16,000 patients found that 24% of variance in serum uric acid levels was attributed to genetic factors, whereas only 1% of variance was attributed to food and diet. However, patients are still advised to follow guideline recommendations regarding diet modifications to avoid high-risk foods. Lifestyle changes are still indicated to help prevent acute gout attacks. This is especially important considering a new survey which found that more than one fifth (22%) of adults with arthritis have anxiety. What's more, 12% of patients with arthritis report depression. Those seeking to help patients avoid these serious comorbidities no doubt helped gout become this week's top trending clinical topic.
For more information on gout, read here.
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Cite this: Ryan Syrek. Trending Clinical Topics for October 2018 - Medscape - Nov 30, 2018.