colchicine used - A New Gout Drug. Febuxostat wins marketing approval in the European Union
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A New Gout Drug. Febuxostat wins marketing approval in the European Union

It has taken a very long time for a major new gout drug to be developed and approved. Probably the best gout news in over 40 years, is that Febuxostat, which has been given the trade/brand name of Adenuric, has been approved by the European Medicines Agency for marketing in European Union (EU) countries.


Gout attacks occur suddenly in most of the cases. The first attack is surely going to develop at night, people getting to wake up feeling an extreme joint pain. During gout attack people usually develop the following symptoms: sudden and severe joint pain, swelling, reddish skin around the affected joints and extreme sensitivity in those areas.


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  RULES Calories were restricted to 1,600 a day: 40% from carbohydrates, 30% from protein and 30% from mono and poly unsaturated fats.

Fats Saturated fats, which are among the fats found in meat fat, dairy products, beef tallow (beef dripping) and lard, were swapped for monounsaturated fats (e.g. olive oil, canola oil) and polyunsaturated fats, (oils such as corn, sunflower and soybean oils). However, in the study, participants took polyunsaturated fats from fish. They were advised to eat fish at least four times a week during the study, even fish that are high purine such as mackerel.

Colchicine is also used because it eases the pain cause by gout. The problem with this medicine it's its side effects that can not be tolerated by any patient. Its side effects include diarrhea, nausea, vomiting and abdominal cramps.

This is the first of an article series about this diet. See the bottom of this article for how to read the second article. Natural gout treatment largely involves diet. The most widely touted gout diet for sufferers of "the disease of kings," is the low purine gout diet. The cause of gout theory behind it is that because uric acid is made from purines, and because uric acid is the gout culprit, purine intake from foods and beverages should be restricted.

Generally, Febuxostat has been more effective when UA levels are below 10.0 mg/dL (595 mmol/??mol). However, even if they have been above this level, it has reduced UA levels down to the target in about 40% of study patients at an 80 mg dosage, and by more at higher dosages.

It will also only be used in gout patients who have chronic hyperuricemia (high UA levels) and gout. So if you're a gout sufferer who lives in a European country that's a member of the EU, you can ask your doctor's opinion about whether Febuxostat is suitable for you.

Your uric acid levels will have to be high. If you have gout but normal or slightly raised uric acid levels as some do, it is unlikely to be prescribed.

So in this diet there was moderate restriction of calories and carbohydrate, and control over proportional consumption of carbohydrate, protein and of fats. In the Zone diet the number of calories you get from food should be in the proportions of: from carbohydrates (40%), from protein (30%) and from fat (30%). This is one of the principles at the core of the diet. These proportions, or numbers close to them (getting more or less there is allowed) should be eaten at every meal and snack too. In the study, participants were asked to keep to these proportions at each meal, and they were encouraged to eat 3 to 5 meals and snacks daily, another Zone diet rule.

Gout symptoms occur in three phases. The first phase refers to the sudden onset of a joint pain, especially in the big toe, that lasts more than 5 days, going in some cases up to 10 days or even more. The second period is believed to be a period with no symptoms or attacks. This is the period between episodes. The third phase refers to the untreated cases of gout. In this last phase persistent symptoms develop. During this phase episodes occur more often and cause severe pain.

Refined and simple carbohydrates are found in foods made from refined grains (for example refined flours which are the basis for pasta, breads, cakes, biscuits (cookies) pies, pastries); white rice; and most cereals. And notably from sugars with the exception of fruit sugar,(fructose) and galactose. Simple carbohydrates include corn and other syrups, table sugar and honey; candies (sweets); processed foods with added sugar; and some fruits and vegetables.

In the beginning of the disease rare episodes are happening. In that phase episodes do not last a long period of time. More than that after an episode everything seems to be going back to normal and between episodes no symptoms occur. It is recommended for the disease to be treated with medication in order to prevent the more often occurrence of these episodes. If gout is not treated the episodes might last longer and might occur more often too. The repeating episodes might lead to a damage of the affected joints, causing limited mobility after any attack.

You will not need to be on a low purine diet, and more good news is that it can be prescribed for the elderly. Kidney and liver disease In trials it has performed quite well with patients who have mild kidney disease. 44% of patients achieved the target at an 80 mg dosage, more at higher dosages. Better results than Allopurinol. If you have mild kidney disease (renal impairment) or mild liver problems (hepatic impairment) your doctor will judge whether Adenuric/Febuxostat can be taken safely.

There isn't space in this article to explain more about the difference between complex and refined carbohydrates. If you're not sure, the subject is easily researched on the Internet. For example, do an Internet search for "Glycemic Index," or "Glycemic Load."

And it may cause side effects of course. See the bottom of this article. Febuxostat (Adenuric) is not unfortunately a treatment for gout pain. It won't be used instead of NSAIDS like Indomethacin, Colchicine, and corticosteroids.

But some studies have found that a low purine gout diet has no effect on uric acid levels. Most likely one reason is because most uric acid in the body is made in the liver from purine molecules of DNA and RNA, and not from the purines in foods and beverages. Another reason may be that the problem for a gout sufferer is not that he/she is producing too much uric acid but that he/she is not excreting enough.

Complex carbohydrates are lower on the Glycemic Index (GI) scale than refined carbohydrates because they have a slower effect on blood glucose, and so the response of insulin to blood glucose is slower and more moderate. Insulin is much more responsive to refined and simple carbohydrates.

Tophi If you have tophi, it's heartening to know that Febuxostat has been shown to have success against tophi. Measured tophi areas reduced in many patients with tophi. The presence of tophi will be an additional factor in favour of a decision to prescribe Febuxostat (Adenuric).

Corticosteroids are also used but not as often as NSAIDs or colchicine because they do not have the same effect. Chronic gout is usually treated with xanthine oxidase inhibitors or uricosuric agents that help the kidneys to eliminate the excess of uric acid produced in the body.

NB. The contents of this article contain medical information not medical advice. Please always discuss remedies with your doctor or other health care professional before implementing any treatment.

If you are intersted in finding more information about gout you can click on this website http://www.gout-info-center.com. Also you will find there valuable information about gout treatments and gout diet.

IT'S NOT PERFECT In trials its success rate in reducing UA levels down to the important 6.0 mg/dL (357 mmol/??mol) level was not 100%. About 35% of trial patients did not achieve the target. This may have been partly because so many gout sufferers are not UA over-producers, the problem Febuxostat addresses, but under-excretors of uric acid.

To examine whether a diet could affect the markers that show insulin resistance exists, and lower uric acid levels, researchers in South Africa put 13 males, all gout sufferers, on a diet governed by three cardinal rules of the Zone diet, the well-known diet book written in the1990's by Barry Sears PhD.

Approval in one country does not mean approval in another, but the fact that the European Medicines Agency has approved it will carry weight when the medical authorities in other countries consider its approval.

Diagnosing a gout case can be very difficult sometimes. However, there are a few procedures that will help your doctor diagnose gout. Here are some of the medical investigations that you doctor will suggest ti diagnose gout: - a blood test is maybe the first procedure that has to be made in diagnosing gout; a blood test can measure the urate level that you have in your blood; urate is the main cause of gout; however, a person can still have high urate levels in his/ her blood and still not suffer from gout; when raised levels of urate appear in the blood, this can indicate that you have gout, but this can also be caused by other medical conditions or medication that a person takes; furthermore, a person can have normal levels of urate in his/ her body during a gout attack; - after a blood test that can give doctors an idea whether you can have gout or not, to be more sure and to be able to diagnose a gout case, doctors will examine the fluid that is found in your joints; this fluid can be extracted from your joints with the help of a needle; this can show you if indeed you suffer from gout or not; the fluid is then looked at under a microscope and if there are urate crystals( they indicate gout) , then they will be spotted right away; if indeed these crystals of urate are found in your joints, then, the blood test was right and you actually suffer from gout; this examination is not at all painful and it is very useful if your gout case starts very unusual; for example, a gout case can sometimes be mistaken for another rheumatic disease, like rheumatoid arthritis and gout can mimic this diseases very well; - another investigation that can be made to diagnose a gout case is x- ray; x- rays of your joints can betaken to see whether you suffer from gout or not, but unfortunately in most of the cases, everything will appear normal and your doctor will not be able to tell if you have gout or not;

 
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There is another cause of gout theory, which is that excess uric acid (hyperuricemia) is the result of insulin resistance, the pre type 2 diabetes condition. Insulin resistance in gout has been the subject of many studies. Simply put, insulin resistance is the condition where the cells become more resistant to allowing insulin to deliver glucose (mainly broken down from carbohydrate in foods) to them, for the purpose of energy creation. It's as if the jailer refuses to open the door of the cell. It's one of the causes of excess insulin. Excess insulin has been found in a number of studies to inhibit uric acid excretion as well as causing other problems.

Noted possible side effects dizziness, drowsiness, diarrhoea, rashes, headaches, hypertension and liver function abnormalities - considered mild ones. In trials none of these side effects were reported in more than 3.5% of trial patients. The most common were liver function abnormalities.

Anyone going on the Zone diet will have their personal daily carbohydrate, protein, and fat requirement. How to discover it is explained in Barry Sears' "Enter the Zone" book. The amount of protein you can eat determines the amounts of carbohydrates and unsaturated fats, in the 4:3:3 proportions, you can eat. Why the 4:3:3 rule is important is also explained in the book. If you know about soccer, you can think of the 4:3:3 rule as the commonly used soccer team formation. Or, another way of putting it, is to say that calories from protein are 0.75 (75%) of calories from carbohydrate and calories from fat are in the same proportion as calories from protein. Getting almost to 4:3:3 is allowed.

Refined carbohydrate foods were swapped for complex carbohydrate foods. i.e. they ate complex carbohydrates, not refined carbohydrates. Complex carbohydrates can be found in foods made from whole grains, (eg. whole grain flours and products made from them), and in many vegetables, low sugar fruits and beans.

BENEFITS In large trials Febuxostat (Adenuric) has outperformed Allopurinol, the most common gout medication for long term treatment. Like Allopurinol, it works to lower uric acid production by inhibiting xanthine oxidase, an enzyme required to produce uric acid. In two major studies it reduced uric acid (UA) in more gout sufferers, and more patients reached the target 6.0 mg/dL level more quickly, than did those on Allopurinol.

For more information about gout treatments please review http://www.gout-info-center.com/gout-symptoms.htm or even http://www.gout-info-center.com/gout-treatments.htm

WHO WILL BE PRESCRIBED IT? The recommended dose is one 80 mg daily tablet. If after two weeks there is no reduction in UA levels, your doctor may increase the dose to 120 mg daily. Patients will need another serum UA test after two weeks treatment to find out how well it's doing. In trials it has usually worked quickly, within a couple of weeks.

This approval applies only to EU countries. Febuxostat has not yet been approved in the United States. If you are reading this from a non-EU country, or the US, you can check with your doctor to find out whether, or when, Febuxostat will be approved in your country.

NB. The contents of this article contain medical information not medical advice. Please always discuss remedies with your doctor or other health care professional, before implementing any treatment.

Meat and Alcohol They also ate meat, no doubt lean meat since mono and polyunsaturated fats were encouraged. (Meat does contain both these fats, as well as saturated fats). Participants' alcohol consumption was moderate, there were no alcohol rules, and it remained the same as usual.

All these symptoms might be a cause of an unhealthy diet or even the cause of too much alcohol drinking. Beside these factors that may lead to gout we also need to mention that gout may occur after a surgical intervention, after a sudden and severe illness or after chemotherapy. An injury to a joint might also lead to development of gout.

At 120 mg it has reduced UA levels to the target of 6.0 mg/dL in over 60% of study patients. At 80 mg the numbers were around 51%. Allopurinol at a 300 mg dosage in most participants achieved this is 22% of study patients. Hence the excited buzz in rheumatology circles since these kinds of results became apparent in its trials. At or below 6.0 mg/dL gout is more likely to be cured or managed better.

Gout is a form of rheumatism that can also lead to arthritis. It is a very painful medical condition that mostly affects men of all ages. Gout can also be found in women, but mostly those who have reached menopause.

It is recommended that NSAIDs or Colchicine are used along with Adenuric. This is because, as with Allopurinol, on a course of Febuxostat, there may be an initial increase in gout flares. If this happens you must battle through the attacks and continue taking Adenuric.

John Mepham has lost track of the number of hours he has spent researching gout treatments. His best tip for curing gout naturally? Get to your ideal weight whatever the sacrifices may be. Learn more about natural gout treatment at www.gout-smashers-guide.com It's an e-book with an emphasis on natural gout treatment

Gout is a problem that definitely needs treatment. Many ways of easing the pain or avoiding the severe attacks are known. Doctors recommend the patients in most of the cases good rest and to increase the amount of fluids that they drink. This is recommended for the easy forms of gout. Acute gout has to be treated with medicine therapy in order to decrease the pain and inflammations in the joints. The drugs usually prescribed for acute gout are non-steroidal anti inflammatory drugs (NSAIDs) such as indomethacin, ketoprofen, oxaprozin, diclofenac, ibuprofen and others.

If you have severe kidney or liver problems Febuxostat is not recommended since it has not been tested in these patient groups. It is not recommended for people with heart disease or children.

Now please visit the second article: Natural Gout Treatment - The Results Of A Gout Diet That Had A Lot Of Success

John Mepham has spent much time researching gout. His best tip for curing gout naturally? Get to your ideal weight whatever the sacrifices may be. Learn more about this study and about natural gout treatment in detail at www.gout-smashers-guide.com/ It's an e-book with an emphasis on natural gout treatment The Zone diet, and other books by Barry Sears, are available at the Official site of The Zone Diet The books can be found by clicking on the products tab on the home page.


 
 
     
 
 





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