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Last Updated: Sunday, 9 May, 2004, 01:24 GMT 02:24 UK
Gout treatments 'remain unproven'
Anti-inflammatory drugs are often used
There is little scientific evidence to support the use of some current treatments for gout, researchers say.

The condition is usually treated with an anti-inflammatory drug, or with alternatives such as steroids.

But the journal Drug and Therapeutics Bulletin says much of the evidence for their effectiveness is anecdotal. Other experts have disputed that claim.

Gout affects around 600,000 people in the UK and is becoming increasingly common in men.

Gout generally involves very severe attacks of joint pain followed by long periods of remission.

The condition is caused by the formation of urate crystals within joints and other tissues.

Acute attacks are usually treated with an anti-inflammatory drug - in many cases indometacin.

However, the DTB says there are no published studies showing whether this is the most effective treatment.

In fact, it says there is evidence to suggest that indometacin is no better, or more easily tolerated than other anti-inflammatory drugs.

Some people - for instance those with stomach ulcers - cannot take anti-inflammatory drugs.

In these cases doctors rely on alternative treatments such as colchicines and steroids.

However, the DTB says their use is based more on anecdotal experience than on published research.


The journal also raises questions about preventative drugs commonly prescribed to many patients to try to stop further attacks - drugs, which in many cases, may be taken for years.

Again, the journal says there is little published evidence on the effectiveness of such treatment.

It says patients, rather than GPs, should make the decision on whether and when to start to take such medicines long term.

Joe Collier, editor of Drug and Therapeutics Bulletin, said: "It is astonishing that we know so little about how best to treat the common (and very painful) condition gout.

"The drugs used are old, so there is no drive to do the necessary research. This is an unacceptable position and needs remedying."

The journal says there is some evidence to suggest that adopting a healthy lifestyle can cut the frequency of acute gout attacks.

Shedding excess weight and avoiding high alcohol consumption are all thought to help.

Claims disputed

But Dr Michael Snaith, a consultant rheumatologist in Derbyshire and expert on gout, told BBC News Online that the criticism of current treatments had been over-egged.

He said it was true to say that different anti-inflammatory drugs were equally effective at treating gout - but he said that as a group they were a highly effective way to combat the condition.

"Most developments in gout occurred in the middle third of the last century before electronic databases were set up - these researchers may not have gone back far enough," he said.

"For instance, there is undoubtedly hard evidence of the effectiveness of Allopurinol, a drug developed to treat cancer in the 1950s, preventing gout attacks by reducing uric acid levels."

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