Health Team

Duke doctor develops drug for gout

With gout, a person’s body isn’t able to get rid of enough uric acid in the urine, so it builds up in the blood and ends up as crystals in soft tissues and joints, causing a lot of pain.

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DURHAM, N.C. — With gout, a person’s body isn’t able to get rid of enough uric acid in the urine, so it builds up in the blood and ends up as crystals in soft tissues and joints, causing a lot of pain.

The vast majority of patients find relief with current medications, but until now, those with the most severe cases had no drug options.

In a Duke University Hospital clinical trial two years ago, about 10 percent of the gout sufferers participating found no drug could offer relief from their disabling pain.

“I couldn't shower myself. I couldn't tie my shoes, I couldn't dress myself,” study participant Janet Wheeless said.

Participant Lonnie Matthews was miserable. “I had so long felt like life wasn’t worth living,” Matthews said.

“If the disease isn't controlled well, then eventually the pain is chronic and doesn't completely go away ever, and there can be destruction in the joints,” Duke rheumatologist Dr. Michael Hershfield said.

In 1993, Hershfield started the development of a new drug for the most severe gout cases. The U.S. Food and Drug Administration recently approved Krystexxa for intravenous treatments twice a month.

Hershfield said the drug contains an enzyme that will degrade uric acid.

With lower levels of uric acid in the blood, the sharp crystal deposits in patients' joints and soft tissues disappeared, along with the unbearable pain.

“My hands were back like they used to be. It saved my life,” Wheeless said.

“I have heard the stories of the patients, and they're very satisfying to me,” Hershfield said.

Krystexxa should be available to gout sufferers by the end of the year.

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