How Does Gout Affect Risk of Colon Cancer?

MedicalResearch.com Interview with:

Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine

Dr. Michael Pillinger

Michael Pillinger, MD
Professor of Medicine and Biochemistry and Molecular Pharmacology
NYU School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We are interested in the co-morbidities of gout and the fact that gout is accompanied by multiple cardiovascular, renal and other events. The implications of gout for cancer are less clear, but the basic biology suggests that either:

1) the acute and chronic inflammation of gout could contribute to a pro-cancer environment;
2) the anti-oxidant effects of urate could have anti-cancer properties;
3) the ability of uric acid to serve as a “danger signal” released from dying cells (potentially including cancer cells” could promote anti-cancer immunity.

The clinical literature is murky at best.

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No Increased Risk of Chronic Kidney Disease with Allopurinol Use

MedicalResearch.com Interview with:
Dr. Ana Beatriz Vargas dos Santos
Médica do Serviço de Reumatologia
Universidade do Estado do Rio de Janeiro

MedicalResearch.com: What is the background for this study?

Response: Gout is the most common inflammatory arthritis worldwide and, despite available treatment, the management of gout remains suboptimal. One of the reasons for this suboptimal management of gout is the hesitant use of urate-lowering therapy, including a common reduction in dose or discontinuation of allopurinol in patients with gout who have kidney dysfunction based on the assumption that allopurinol may be worsening kidney function. However, there is no evidence that allopurinol is toxic for the kidneys, and this dose reduction or discontinuation results in more difficult-to-treat gout.

Chronic kidney disease (CKD) stage 3 or above occurs in approximately 20% of people with gout, and there is emerging evidence that urate-lowering therapy may improve kidney function in patients with both gout and CKD. Although CKD is common, most people with gout start out with normal kidney function. Yet, there are limited data regarding the effects of allopurinol on kidney function in such individuals. We, therefore, undertook this study to assess whether people with newly diagnosed gout who are starting allopurinol are at increased risk for developing CKD stage 3 or worse.

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Juvenile Arthritis: TNF Inhibitor Use Doesn’t Appear To Increase Malignancy Risk

MedicalResearch.com Interview with:

Timothy Beukelman, MD, MSCE Associate Professor of Pediatrics Division of Rheumatology and Division of Clinical Immunology & Rheumatology University of Alabama at Birmingham

Dr. Timothy Beukelman

Timothy Beukelman, MD, MSCE
Associate Professor of Pediatrics
Division of Rheumatology and
Division of Clinical Immunology & Rheumatology
University of Alabama at Birmingham

MedicalResearch.com: What is the background for this study?

Response: In 2009 the US FDA issued a boxed warning about malignancies reported in children treated with TNF inhibitors but their analysis did not account for a possible malignancy risk from other medications of from the Juvenile idiopathic arthritis (JIA) disease process itself.

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Increased Cardiovascular Risk in Rheumatoid Arthritis Comparable to Diabetes

MedicalResearch.com Interview with:
Prof.dr. M.T. Nurmohamed, MD, PhD
and
Rabia Agca MD
Dept. of Rheumatology | VU University Medical Center
Amsterdam Rheumatology & immunology Center
EULAR center of excellence in rheumatology

MedicalResearch.com: What is the background for this study?

Response: About 20 years ago the increased mortality in rheumatoid arthritis (RA) was well known, but not the causes. In daily clinical practice it seemed that RA patients more frequently suffered from myocardial infarctions than general population persons. Therefore, we started this study more than 15 years ago as at that time there were only sparse data with respect to cardiovascular morbidity in rheumatoid arthritis.

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