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There are lots of useful sources online to provide more information about gout, such as WebMD or UpToDate for Patients. Based on what my patients ask me in the office, a lot of the patient education information seems to focus on management of diet to control gout. Certainly dehydration can precipitate a gout attack, so remaining hydrated is usually recommended (keeping in mind some patients may be on fluid restriction for other medical conditions). A 2004 article in the NEJM concluded that,
Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk.
Among the medications used to treat and prevent gout is another oldie but goodie, a medication called colchicine. In early December some preliminary emails were circulated with rumors that this inexpensive generic medication was going to be removed from the market and a more expensive brand name medication would take its place. These rumors were confirmed and can be read about in more detail in this article, which appeared in several newspapers. According to the article,
In December, the American College of Rheumatology sent a letter to the FDA seeking to discuss how to keep colchicine affordable. “We want to express our concern that a medicine used for centuries to treat gout and rare conditions, which costs pennies, will now cost patients quite a bit more,” said Dr. Stanley Cohen, a Dallas rheumatologist who is president of the college, in an interview. “That doesn’t make sense in the setting of healthcare reform.”
I’m afraid it doesn’t make much sense to me either. Gout (and Familial Mediterranean Fever, the other condition for which colchicine is commonly used) is not a very fancy disease. No one is wearing gout awareness ribbons. But ask anyone who has suffered a severe gout attack how important it is to him or her to have treatment options. In our current healthcare climate, it seems like affordability of these options would be of particular importance. Wonder why we’re not hearing more about this.