June 23, 2022

Chronic Gout: Symptoms and Treatments

Specialty Infusion Blog Jess

Gout is arthritis that affects the joints and produces severe pain, swelling, and stiffness. The metatarsophalangeal joint is primarily affected by gout at the base of the big toe. The primary reason is accumulating a high amount of uric acid in the body.

The most prevalent inflammatory arthritis in men is gout, affecting over 3 million Americans. Females are more prone to gout after menopause, even though the disease affects them less.

Gout episodes may strike suddenly and may repeat over time. This continuous recurrence may cause tissue damage at the inflammation site over time and can be extremely painful. Gout is caused by high blood pressure, cardiovascular disease, and obesity.

Chronic Gout

Chronic Gout

Some people have only acute gout episodes once or twice a year (or even 1-2 times in a lifetime). Gout may, however, be a chronic, recurring condition for certain people, with several acute symptoms occurring at short intervals and no full clearance of inflammation between attacks.

This gout, known as chronic gout, may lead to the destruction of joints and deformity and may be misinterpreted as chronic inflammatory arthritis, including rheumatoid arthritis.

Uric acid tophi (hard, uric acid deposits beneath the skin) are common and contribute to the deterioration of bone and cartilage. Tophi diagnose chronic tophaceous gout. Tophi may be present in the olecranon bursa, the olecranon bursa, or the ear’s pinna. Finally, tophi may be dissolved with therapy and will eventually dissolve.

Chronic tophaceous gout is the most devastating gout and may cause irreversible joint and kidney impairment. Individuals with chronic arthritis and tophi in colder parts of the body, like the joints of the fingers, might develop tophi at this stage.

After several years of acute gout episodes, chronic tophaceous gout develops. But, individuals who get good therapy are unlikely to reach this level.

Symptoms of Chronic Gout

What follows are the signs and symptoms of chronic gout that may occur suddenly, especially at night.

Intense Joint Pain. 

Gout is often concerned with the big toe, although it may affect any joint. The other joints typically afflicted are ankles, knees, elbows, wrists, and fingers. The pain will likely be the worst during the first four to twelve hours after it starts.

Persistent Discomfort. 

Some joint soreness may remain from a few days to a few weeks after the most acute pain has subsided. Episodes are more likely to continue longer and damage more joints.

Presence of Inflammation and redness. 

Swollen, sensitive, heated, and redness develop in the afflicted joint or joints.

Limited range of motion.

Your movement may become restricted with chronic gout’s intense pain and discomfort.

Gout Treatment

Medical therapy and self-management measures may treat and control gout. Your health care physician may recommend a medical treatment strategy to manage gout-related pain.

  • Nonsteroidal anti-inflammatory medicines (NSAIDs), including ibuprofen, steroids, and the anti-inflammatory drug colchicine, are used to treat flares.
  • Making dietary and lifestyle adjustments to avoid future flare-ups, including decreasing weight, restricting alcohol, and eating fewer purine-rich foods (such as red meat or organ meat), may help prevent recurring attacks.
  • Changing or quitting hyperuricemia drugs (such as diuretics) may also assist.
  • Tophi and kidney stones may result from chronically elevated uric acid levels. Tophi are uric acid deposits beneath the skin that are hard and painful.
  • Preventive treatment to decrease uric acid levels in the blood with medications like allopurinol, febuxostat, and pegloticase may be recommended for those with recurrent acute flares or chronic gout.

Chronic Gout and KRYTEXXA 

Chronic gout treatment is now possible with KRYSTEXXA, which works by changing uric acid into a water-soluble substance known as allantoin. It can be removed through urine from the body. Some have observed that administering only one IV dose of KRYSTEXXA lowers uric acid levels—it does this by dissolving them. It is possible to clear uric acid crystal build-ups that were deposited many years ago.

KRYSTEXXA is the only FDA-approved medicine to treat chronic gout. For more than ten years, it has been the only drug used by the patients to control chronic gout otherwise not controlled or treated by other medicines. According to research studies, the results can be seen with 1 IV treatment every other week for almost six months.

Important information you should know about KRYSTEXXA?

Sometimes, individuals who get KRYSTEXXA may experience severe allergic reactions. These allergic reactions can be fatal and usually occur within two hours after receiving the infusion.

A doctor or nurse should only administer KRYSTEXXA in a facility where severe allergic reactions can be managed. During and after your treatment with KRYSTEXXA, your doctor or nurse should watch for any signs of a significant allergic response.

Administration and Dosage:

KRYSTEXXA is administered via intravenous infusion bi-weekly.

Common Side Effects of KRYSTEXXA. :

The following are the common side effects of KRYSTEXXA.

    • Fast or weak heartbeat
    • Throat tightness
    • Swelling of tongue or throat
    • Hoarse voice
    • Trouble swallowing
    • Feeling warm
    • Chest pain
    • Breathing issues
    • Fainting
    • Nervousness
    • Hives
    • Itching
    • Rashes
    • Shortness of breath
    • Wheezing sound
    • Chest tightness
    • Dizziness

Precautions for KRYSTEXXA.

Before you receive KRYSTEXXA, tell your doctor if you:

  • If the doctor prescribes you KRYSTEXXA, tell your doctor if you:
  • If you have a known deficiency of G6PD .
  • If you have suffered from or currently have high blood pressure and heart problems.
  • In cases where a female is pregnant or wants to become pregnant; it is unknown whether KRYSTEXXA will harm your unborn baby.
  • If you are breastfeeding or plan to breastfeed, it is unknown if KRYSTEXXA affects your child if it passes into breast milk.
  • Make a list of all your medications and provide it to your doctor. While taking KRYSTEXXA, take no other uric acid-lowering medication, including allopurinol or febuxostat.
  • Your doctor may prescribe medicine to help you avoid a reaction before you begin treatment with KRYSTEXXA. Follow the instructions of your doctor or nurse for taking these medications. To monitor your response to KRYSTEXXA, your doctor will test your uric acid levels before each session.

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