Combining Medications Shows Promise for Gout Patients

July 21, 2020

New research offers a ray of hope for people living with uncontrolled gout.

While most patients can manage gout through medication and lifestyle changes, some people don’t find traditional medication effective. Their uncontrolled gout can lead to excruciating flares – painful episodes caused by uric acid build-up in the joints.  Flares can be longer or more frequent if a person’s gout is uncontrolled. Uncontrolled gout also can cause lasting joint damage and introduce additional health risks.

In recent years, some uncontrolled gout patients have found relief through an infused medication called pegloticase. The treatment has restored quality of life for people who previously struggled for years to control their gout. A small number of people with uncontrolled gout, however, did not succeed even with the infused medication.  Whether because their bodies couldn’t tolerate the medication or because they developed antibodies to it, patients who haven’t responded to pegloticase seemed to be out of treatment alternatives. 

Then researchers identified a new option.

A recent study found that adding a second medication, called methotrexate, along with the infused treatment could double the success of patients’ response. Before receiving the two medications together, patients in the study had about 12 flare-ups a year. After treatment with both medications, most patients had no flare-ups at all. Those who did had fewer than three a year.  

The findings suggest that, by taking the two medications in combination, more patients with uncontrolled gout could derive a benefit from pegloticase – decreasing the number of attacks and reclaiming their quality of life.  John A. Albert, MD, a study author and rheumatologist, is embracing the new approach as standard of care in his practice. It helps patients return to a “normal life,” he noted.  

Normal life can be hard with uncontrolled gout. Attacks can make it difficult to walk, work or participate in daily life. By introducing a treatment alternative where patients thought none were left, the new finding underscores the importance of ongoing research and innovation to improve the treatment of gout.

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