New research: How to avoid gout attacks
Many people with gout live with repeated, extreme pain. New Norwegian research shows that the disease can be controlled. For most people, attacks can disappear completely if they receive the right treatment.
If you want to test an app that can support you to become pain-free, click here
A five-year study from Diakonhjemmet Hospital provides a clear answer: If you keep uric acid low over time, both attacks and the actual cause of the disease can disappear.
– We see that the crystals that trigger the attacks actually dissolve when the treatment is followed over time, says rheumatologist and professor emeritus, Hilde Berner Hammer.
The seizures stop with proper treatment
Gout is caused by small crystals of uric acid that deposit in the joints and cause inflammation. These can cause very painful attacks – often so intense that even a sheet against the skin hurts.
In the study, the researchers followed over 200 patients for five years. All received uric acid-lowering treatment with the goal of keeping uric acid levels low.
The results are clear:
- Over 70 percent reached the treatment goal
- The crystals in the joints were greatly reduced or completely gone in most people
- After five years, only 16 percent still had seizures
Those who still had seizures had one thing in common: their uric acid levels were still too high.
– The most important finding is that the disease can not only be slowed down – it can in practice be brought under control. But that requires that uric acid is kept low over time, says Hammer.
Not enough to treat when the pain comes
Today, many people only receive treatment when the attacks occur. It may help then and there – but does nothing to address the cause.
“If you just suppress the seizures, the crystals will remain. Then new seizures will come, often more frequent and more severe,” says Hammer.
The study shows that proper treatment can prevent new attacks: When uric acid is kept low long enough, the crystals gradually disappear. Without crystals – no attacks.
“This is the key. The treatment must be long-term, just like with high blood pressure or cholesterol,” she says.
Many people drop out of treatment
Although the treatment is effective, there is a major challenge: Many people stop when they feel better.
Then the uric acid builds up again – and the disease can once again drive you crazy.
– This is a paradox. We have treatment that works, but many people do not benefit from it because they do not follow up on the treatment over time, says Hammer.
Testing app that will help patients
Now researchers are trying to find a solution.
In a new study, they are testing an app that will make it easier to follow treatment in everyday life. The goal is to help patients keep uric acid levels low – and thus avoid new attacks.
“We want to see if simple digital support can make it easier to cope with the disease,” says postdoctoral fellow Fiona Aanesen, who leads the study.
The app provides an overview of uric acid levels, reminds you of medications and blood tests, and shows your progress over time.
– The goal is simple: that more people actually manage to reach the treatment goal and keep their uric acid levels low, so that they avoid attacks, says Aanesen.
If it turns out that the app works well in practice, the researchers will test this in a larger study.
Treatment must be followed over time
The researchers believe the findings should have consequences for how the disease is treated.
Gout is not something you just have to live with.
– This is a disease that we can largely control. But then the treatment must be followed – and followed over time, says Hammer.
For patients, this means a real opportunity:
Fewer attacks. Less pain. And for many – a life without symptoms.
Fact box
The article about five-year follow-up of gout: https://www.sciencedirect.com/science/article/pii/S0003496725045170?via%3Dihub
Gout:
- The most common inflammatory disease of the joints
- Caused by uric acid crystals that deposit in joints and cause inflammation
- It is estimated that 1-2 percent have uric acid in the Nordic countries, around 50 – 100,000 in Norway Sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC5133407/
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1540190/full - The chance of getting it increases with age, and up to one in ten older men are affected by gout. (One in twenty over 50)
Symptoms:
- Sudden, very painful attacks (can't even have a sheet on the area)
- Often in the big toe, but also other joints
Treatment:
- Acute: reduce inflammation (e.g. NSAIDs or prednisolone)
- Controlling the disease: lowering uric acid levels over time with uric acid-lowering medication (e.g. allopurinol)
Key findings from research:
- Low uric acid levels over time prevent the formation of new crystals
- Fewer crystals mean fewer seizures
- No crystals provide absence of seizures
The challenge:
- Many people stop taking uric acid-lowering treatment or are undertreated. Then the attacks often return
