14 Thursday May 26 2022 | the times
News
Gout sufferers are not getting proper
treatment, with only one in three re-
ceiving preventative medication within
a year of diagnosis, research claims.
Gout is ever more common, driven
by higher levels of obesity and diabetes,
in an older population, experts say.
The condition, a form of inflammato-
ry arthritis that affects one person in
40, is caused by high levels of uric acid
(urates) in the blood, which can form
crystals in joints and other tissues.
People suffer recurrent severe joint
pain and swelling, and not treating gout
can damage joints and organs.
A study, published in The Lancet Re-
gional Health, found that most gout
patients were not receiving medicine
designed to lower urate levels, despite
the drugs being low cost and highly ef-
fective. Guidelines, updated in 2017, en-
courage the prescribing of medications
such as allopurinol.
Researchers from King’s College
London used data from doctors’
records to look at the treatment of
129,000 people diagnosed with gout in
Britain between 2004 and 2020.
They found only “modest improve-
ment”, with 27 per cent of patients
prescribed the drugs in 2004, rising to
37 per cent in 2019, and falling to 35 per
cent as the pandemic hit in 2020.Gout sufferers are denied
effective pills as cases rise
Dr Mark Russell, the lead author of
the study, said: “These results were
quite surprising as the initiation of
treatment is straightforward, and the
medications we use to treat and prevent
gout have been around for decades, and
are cheap. Our data indicate that we
have a lot more work to do.”
He called for strategies to encourage
the prescription of preventative medi-
cations: “Educational programmes
could help to raise awareness about the
importance of medications such as al-
lopurinol in the prevention of recurrent
flares and disability due to gout.”
Russell said another option might in-
clude targets for prescribing that doc-
tors needed to reach to access funds.
The researchers found only one
patient in six achieved the target blood
urate level recommended by the British
Society for Rheumatology.
They said that this problem was not
limited to those treated by GPs, with
other studies showing those treated in
specialist clinics also frequently failed
to achieve the target levels necessary to
prevent the condition flaring up.
Dr Asim Suleman, a pain manage-
ment expert for the charity Versus Ar-
thritis, said: “It’s simply unacceptable
that far too few people are receiving the
effective treatments they need for this
entirely preventable, excruciating, and
surprisingly common condition.”Kat Lay Health EditorWILL EVANS/BNPSJavid rethinking
ME after young
relative’s battles
The health secretary has spoken of a
young relative’s battle with myalgic en-
cephalomyelitis (ME) as he promised a
new approach to the debilitating illness.
Sajid Javid said that the health ser-
vice had failed in its attitude towards
treatment of the illness but pledged to
lead a cross-government initiative on
ME. This would involve healthcare,
education and the benefits system,
while placing a new emphasis on
research into the poorly understood
condition. He will convene a panel next
month with researchers from around
the world in an effort to encourage new
treatments.
Speaking at the launch of Rethinking
ME, an all-party parliamentary group
report, the health secretary disclosed
that a close family member had been
struggling with the chronic illness for
six years. At the age of 12, his relative
had gone within weeks from being an
active girl who captained her school
netball team to one who struggled with
fatigue and low energy. Her school-
work had suffered and doctors had
been unable to explain her illness or
offer any treatment.
Javid said he felt that once they had
given a diagnosis of ME, doctors had
nothing to offer his relative. “She is now
18 and there is still no improvement.
She is desperate to get on and do things
and there’s no end in sight,” he said.
“Some clinicians try their best but I
don’t think the system as a whole realis-
es how serious this issue is and how it
has been neglected for far too long”.
At least 250,000 people in the UK
have ME, which affects more women
than men. Common symptoms includepain, profound fatigue, post-exertional
malaise, gastrointestinal problems and
cognitive dysfunction.
There is renewed interest in the con-
dition, partly because of significant
overlaps with long Covid in terms of
symptoms and post-viral triggers.
The cross-party report said that a
“turning point” had been reached in
accepting that ME is a physical rather
than a psychological condition but that
work remains to be done to bring about
change for patients.
The report said: “People with ME
require major cultural change to take
place within all professions associated
with their care and support. Sadly, false
and outdated understandings of ME
still circulate within medical and public
discourse, making it more difficult, and
often impossible, for people with ME to
access the services to which they are
entitled.” It continued: “The ME
community and their advocates within
the medical profession and wider
society have made significant strides in
challenging erroneous understandings
and pressing for improved care.”
The report called for the new NICE
treatment guidelines to be fully imple-
mented across the health service. It
added: “There has been a long-term
disconnect between the treatment
deserved by people with ME and what
they experience in reality. This discon-
nect stems from... a lack of under-
standing of the biomedical nature of
ME amongst many professionals
associated with caring for and support-
ing people with ME, the absence of
sustained research funding to develop
our understanding of the underlying
disease mechanisms, and a scarcity of
evidence-led clinical services.”Sean O’NeillDouble bow A pair of rainbows, formed when light reflects twice in raindrops and with colours reversed in the outer band,
caught on camera over Mudeford Quay near Christchurch, Dorset. They are more likely in low sun, early or late in the day