Anyone else with gout try Colchicine?

[mossguy]

Art,
I am on that same regimen. No pain, no side effects!
Gutes Besserung!

[azasadny]

Tom,
Thanks, you're one of the reasons I've decided to try it. After my disastrous experience last weekend, I'm getting desperate for some relief! Thanks again!!

[TimT]

I have had a few episodes of gout..

Cannot imagine the pain of getting an injection of steroids into the joint.. a slight breeze over the toe is painful.. let alone trying to put a shoe on...sticking a needle in the joint and increasing the pressure.....

I can't imagine that sort of pain.... which is why I never went for the steroid injection..

Sour cherries work wonders for me...Amazing actually.. I can eat a few cherries, or down some extract, and relief is almost at hand..

Then again I don't have chronic gout.... an episode every few years, and I can pretty much predict when it will happen... If I "fall off the wagon" regarding my weight... diet... alcohol.. I run up the pounds..and then get that twinge in my big toe that lets me know I have two weeks of misery ahead of me..

[azasadny]

The low dose daily Colchicine is making me sick, lots of nauseaand I feel like I'm being poisoned, so I am going to stop taking it and stick with daily Allopurinol by itself.

[mossguy]

Sorry to hear that, Art. I hope the Allopurinol does it for you. It's nasty when the cure is as bad as the disease. Were you required to make any life-style changes?

[azasadny]

I've made every lifestyle change possible to no avail. No red meat, no alcohol, no high fructose corn syrup, no fried foods, 3-4 liters of water daily, not overweight, etc... For almost 4 years and the gout has been unstoppable...

[mossguy]

Sounds like you've done it all. No changes left to make.

[azasadny]

Yep, my new Dr is concerned that my gout has not responded at all even with my SUA at 4.3, it's very strange...

[jyl]

Gout is a poorly treated disease, a study shows 65-70% of patients treated for gout with allopurinol and colchicine do not reach sUA < 6mg/dl and 60-65% still have flares.

There is another approved gout drug from Takeda, Uloric (febuxostat), that you could ask your doctor or a rheumatologist to consider. AFAIK, used to reduce sUA more effectively than allopurinol, no apparently improvement in flares, so not obviously a silver bullet for you, but your doctor may have more insight.

Regeneron is developing Arcalyst (rilonacept), specifically to reduce gout flares. Phase 3 trial showed patients on the drug had 73-80% fewer flares than patients on placebo. This drug is on the market already, as it is FDA-approved for a different (auto-inflammatory) disease. It will likely be approved by the FDA for gout in mid/early 2012, but you could ask your doctor to consider prescribing it off-label.

Go here for general Arcalyst info - REGENERON >Clinical Pipeline > Rilonacept IL-1 Trap

Go here for the press release on the latest of multiple phase 3 trials of Arcalyst in gout - Regeneron Pharmaceuticals, Inc. - ARCALYST® (rilonacept) Meets Primary and All Secondary Endpoints in Second Phase 3 Trial for Prevention of Gout Flares in Patients Initiating Uric Acid-Lowering Therapy - I assume you and your doctor will want to examine the liver safety signals, if any.

A third drug is being developed by Ardea, RDEA594. Phase 2 trials show significantly better sUA reduction and somewhat better flare control than allopurinol or febuxostat alone, but drug is still 1+ year from market.

I am no doctor, just an investor, so I follow new drugs in development but can't/don't give any actual medical advice. I don't know how conservative your doctor is, or if he/she follows pre-approval drugs and is interested in trying off-label uses. You sound like you're in significant pain.

[imaircooled]

Hang in there Art. We are thinking about you.

[azasadny]

Jyl. Thanks for the valuable info, I'll research those mess!

[azasadny]

Chris,
Thanks!

My last post should have been "meds" instead of "mess". I hate trying to post from the iPhone!

[jyl]

Funny, I didn't notice.

You seen this site?

Damn You Auto Correct! - Funny iPhone Fails and Autocorrect Horror Stories

[azasadny]

That's funny! That auto-correct feature is horrible and I wish I could disable it!

[jyl]

There is a setting, General > Keyboard > Autocorrect ON/OFF

[azasadny]

Thank you!!!

[azasadny]

Major gout attack this week. I could barely drive yesterday and today I went to my Dr. she gave me a shot of Tramadol and a proscription for pills. She wanted to give me a steroid but I can't take those as I have a reaction to them. My SUA was 4.3 in February, so the Allopurinol is lowering that and that's good but we can't figure out why I'm in almost constant gout pain. I'm still taking 300mg of Allopurinol a day and I WILL NOT take Colchicine again!

She mentioned Uloric and a few other meds, but my liver specialist will have to give his permission 1st and he's very concerned about my liver enzymes and wants to keep them low.

My Dr gave me a referral to a rheumatologist since we're both out of ideas. Hopefully, the specialist will figure something out and help me. I'm in a lot of pain, but the shot helped and I take Aleve (naprosen) so I can walk around...

[Tobra]

Wait, you are just now being referred to a Rheumatologist?

[jyl]

You should have been seeing a rheumatologist all along. Glad you are getting to one now, but for me anyway there has always been a substantial wait to get in as a new patient. When you call for an appointment, emphasize that you are having a severe flare right now - it may speed up the process. Print out the info I linked and bring w/ you, the rheumatologist may already be familiar w/ Arcalyst as it is on the market for a disease typcially treated by rheumatologists. Good luck, sorry about the pain.

[azasadny]

Tobra,
Yep... The attitude about gout seems to be "just give them a steroid injection and tell them to avoid rich foods and alcohol"... My situation is a little different in that my liver specialist actively managed my gout until he was convinced that the Allopurinol and Colchicine wouldn't cause my liver enzymes to become elevated again. Once that was done, he said I should see my family doctor for the gout. This was my second visit to my new family doctor and she mentioned the referral right away, especially when I told her about my reaction to the Colchicine.

What I'm concerned about is that I'm having almost constant gout pain with frequent flare-ups, even with my SUA at 4.3. We're wondering if the gout is related to my liver condition ("atypical" NASH)... Hopefully, the rheumatologist will know what to do. There aren't any in my immediate area and it may take weeks to get in to see the specialist... The nurse who took care of me today has RA and she sees this specialist and speaks very highly of him.