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Bone Drug Fails to Treat Severe Gout

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Jarod Cassidy3 years ago

According to Medpage Today, a randomized study has found that bisphosphonate treatment does not prevent the development of bone erosions in patients with severe tophaceous gout.

What is Gout?

Gout is a complex form of arthritis in which high levels of the uric acid build up in the blood, causing pain, stiffness, and swelling in the joints.  

Over a long period of time, the increased uric acid levels can lead to deposits of monosodium urata crystals, called tophi. These formations can destroy skin, tendons, ligaments, and erode bone, causing articular damage.

It has been suggested that osteoclasts, bone cells that resorb bone tissue, play a role in the development in gout related bone erosions due the presence of osteoclast-like cells around urate crystals.

As such, Nicola Dalbeth, MBChB, and her colleagues from the University of Auckland in New Zealand suspected that treatment with agents that impede osteoclast fuction (such as bisphosphonates) could prevent bone erosion.

About the Gout Study

In order to test their hypothesis, Dalbeth and her colleagues enrolled a total of 100 patients diagnosed with chronic tophaceous gout (gout patients who had developed tophi).

The participants had an average age of 56 and had a mean disease duration of 22 years.

Study participants were then divided into two groups: a active group and a control group. Participants in the active group received treatment with the zoledronate (Zometa, Reclast) while the control group received a placebo.

Both the drug and placebo were administered intravenously once a year for two years. CT images and plain radiographs were taken at the beginning of the study and at the end of the first and second year of treatment. Researcher also assessed bone mineral density (BMD) and any markers of bone and cartilage turnover.

By the end of the study, researchers failed to note any significant improvements in patients receiving zoledronate compared to patients receiving the placebo. Researchers also observed higher rates of adverse events in patients taking zoledronate.

Zoledronate Side Effects

The following adverse events have been reported in patients taking zoledronate:

  • Impaired hearing
  • Muscle pain
  • Chest pain
  • Fatigue
  • Abdominal pain
  • Infection
  • Anemia
  • Renal impairment
  • Renal failure
  • Death


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