Over the past two decades, the prevalence has risen from an estimated 2.7 percent of the population to 3.9 percent in 2008, and is estimated to affect more than 8 million Americans, according to a study published last month in the journal Arthritis & Rheumatism.
Along with the increase has appeared a crop of new gout medications; federal regulators have approved three new drugs since 2009. They are the first new gout medications after a 40-year drought, and come with a flurry of recent advertisements from pharmaceutical companies touting them.
The promotions have raised questions among health care providers about whether the new therapies, which can be significantly more expensive, are any better than the conventional ones at treating the age-old disease.
“If you convince a lot of people that there is this terrible disease lurking, then it is hard for Americans not to say, ‘Gee, that new medicine sounds good to me,’ ’’ said Dr. Nortin M. Hadler, an arthritis specialist and professor at the University of North Carolina School of Medicine.
Hadler said that in his experience, the new drugs don’t seem to be more effective than those that have been on the market for decades. A self-described skeptic, Hadler has written extensively about aging and what he calls a growing trend in the medical industry to overuse tests and medications to treat patients.
Yet on some basic points about the disease, Hadler and other specialists agree: People who are overweight, have high blood pressure, take diuretics - a common medication for high blood pressure - and have a diet rich in meat and beer are more prone to gout attacks. (Overindulgence in rich food and drink is what earned gout the reputation as a “rich man’s’’ or “king’s’’ disease - King Henry VIII being one of its most prominent representatives.)
Working from that list, Hannoosh was the perfect gout candidate. While he isn’t overweight, Hannoosh has had high blood pressure since his late 20s, had long been on diuretics, and was a big beef-and-beer guy.
