Top 100 Podiatry Blog
Learn about Injected Drug to prevent gout problems

A new approach to preventing gout attacks looks promising for people not already helped by existing treatments. Researchers are looking at an anti-inflammatory drug called canakinumab (Ilaris) to treat this painful form of arthritis.

Instead of targeting excessively high uric acid levels as existing gout drugs do, the new strategy aims to reduce overall inflammation. The drug goes after a specific inflammatory molecule called interleukin-1.

The result was a 50 percent drop in gout attack risk, the researchers found. "This was a very large effect," said study lead author Dr. Daniel Solomon, a rheumatologist with Brigham and Women’s Hospital in Boston.


He acknowledged it was "very surprising" that the drug packed an equally protective punch whether patients had normal uric acid levels or very high levels.

But Ilaris is unlikely to be the preventive drug of choice any time soon, said Solomon. For one, it has not yet received approval for gout treatment in the United States. And most patients already achieve risk reduction with standard uric acid-lowering treatments, such as allopurinol (brand names Zyloprim, Aloprim).

What’s more, decades-old allopurinol is a cheap daily pill. "Canakinumab is very expensive," said Solomon. Its main role to date is as a last-ditch treatment for rare, so-called "orphan" diseases. At its current price, he said, "it is not a viable option for most patients with gout."

Also, it must be injected every three months by a caregiver. Still, Solomon said Ilaris may have a clinical role for patients who don’t respond to or tolerate standard medications. Prior research had shown that interleukin-1B inhibitors can shorten gout attacks, but it wasn’t known if they could prevent them, the study authors said.

The new research was funded by Novartis, the maker of Ilaris. The results were published online in September in Annals of Internal Medicine. Gout is the most common form of inflammatory arthritis. When a chemical called uric acid builds up in the body, it triggers the formation of tiny jagged crystals that cause severe joint paint, most often in the foot, particularly the big toe. Gout’s prevalence has increased considerably in recent decades.

Heart disease and gout often overlap, the researchers noted. To explore whether Ilaris has potential as a preventive measure, investigators conducted a secondary analysis of the so-called Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). This enlisted more than 10,000 heart attack patients to see if Ilaris might help reduce future cardiovascular complications among high-risk individuals.

The researchers found that patients treated with four injections of Ilaris a year faced half the risk for a gout attack, compared with those given a dummy (placebo) treatment, regardless of uric acid levels. "We have no strong reason to believe that [Ilaris] would be less effective in patients without known heart disease," said Solomon.

Howard Feinberg, a professor of rheumatology at Touro University in Vallejo, Calif., agreed. Based on the current and prior research, "we can assume that this drug will work for most patients," including those without a history of heart disease, he said.

Feinberg said he "would not recommend its use for someone who did well on older medications" because of its high cost and the need to give it as in injection. "The type of patient who would benefit the most is someone who was allergic or could not take standard therapy," Feinberg said, mentioning patients with kidney disease. "This treatment is also ideal for someone whose gout could not be controlled on allopurinol or other older therapies."

Can you do yoga #Barefoot?

Yoga is traditionally done barefoot, and most yogis would probably cringe at the thought of wearing shoes or even socks during their practice. #FreeTheFoot, amirite people? In all seriousness, though, you're probably really accustomed to doing yoga barefoot and don't even give it a second thought at this point — but that might not always be the best idea, according to at least one expert.

I don't know about you, but I think there's something very liberating about being barefoot, whether it's during yoga or even when you're just hanging out around the house. "The fat on the bottom of your foot is the only cushion between your foot bones and the floor." In other words, you know those one-legged yoga poses that test your balance, like...

The hazards affecting your employees’ foot safety

Many jobs require employees to constantly lift, move and work with heavy objects, all while standing for long periods of time. When all of these factors are coupled, it can result in potentially fatal injuries that start with the feet and work their way up the body, affecting knees, hips and backs. Foot injuries can cause enormous backlash for both the employee and employer. For example, with employees, an injury resulting in permanent or long-term foot damage can hinder their ability to work, while employers can be left paying immense amount of workers compensation.

According to the Bureau of Labor Statistics, there are more than 53,000 foot injuries per year leading to missed work days. This means that on average, 4.8 individuals per ...

Choose the right shoes to start school with these shoe shopping tips

Here are some tips to keep in mind when shopping for new shoes:

Your child’s feet change with age

Shoe and sock sizes may change every few months as a child’s feet grow. Be sure to have the size checked at a minimum of every six months.

Shoes that don’t fit properly can aggravate the feet

Always be sure to measure your child’s feet before purchasing a new pair of shoes and watch for signs of irritation (including swelling, blisters or redness) after the initial use.

Ditch the hand-me-downs

Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungal infections such as athlete’s foot and nail fungus.Examine the heel of the sho...

Foot pain may be tied to heart disease!

Your foot and leg pain can be related to heart disease. In honour of the many men and women who are diagnosed with heart disease, we thought we’d talk about the connection between the feet and heart.

Coronary artery disease is narrowing of the arteries in the heart where peripheral artery disease (PAD) is narrowing of the arteries in the extremities and feet. PAD is very common in people with coronary artery disease.

Hardened, narrowed arteries (atherosclerosis) are due to plaque buildup along the arterial wall. The plaque consists of fats, cholesterol, and other substances.

The more the buildup, the more blockage that occurs and in cases of inflammation of the plaque it can break off and cause complete blockage of blood flow.

When there is severe reduction in blood flow or complete blockage, there is tissue damage or death. In the heart, this is considered a heart attack. In the feet and legs, this can be limb-threatening where you are at risk of toe, foot or partial leg amputation.


If you want to wear heels, there's a healthier way to do it

When you wear heels, that throws off the alignment in your foot, that then goes to your ankles, your knees, your hips, your back — your whole skeletal alignment is off, adding extra stress onto the joints, which in turn can cause arthritis over the years.

wearing heels can also cause more acute problems, like stress fractures and neuromas. A neuroma happens when a nerve in the foot gets sandwiched too tightly between bones, growing enlarged and causing pain. And while heels don't actually cause bunions or hammertoes, they can easily make them worse.

The worst part of my heel-wearing experiment wasn't that my feet hurt more than usual. It was that I moved way less than usual.

I love taking walks at lunchtime or post-dinner to stretc...

Review the following factors in order to choose the best shoe

Some people are more prone to toe jam than others

A police officer’s feet endure many stresses, aches and pains associated with prolonged standing and walking as might be seen on a patrol beat, parade duty or traffic accident, as well as the explosive multi-directional bursts of speed required in a suspect foot chase.

Just like athletic shoes, manufacturers have been taking a close look at the demands of public safety, offering a variety of utility shoes and police duty boots in an attempt to make policing a little more comfortable and functional while mitigating acute and chronic lower extremity injuries.

Minimalist and maximalist sound like terms associated with art. In fact, they are associated with a growing trend in footgear t...

What is toe Jam and how to get rid of it?

Some people are more prone to toe jam than others

Although toe jam is common and its causes are nearly unavoidable, certain lifestyles, footwear choices, and medical conditions can make you more likely to find crud between your toes. People who are on their feet for longer periods of time, individuals who have a tendency to sweat more profusely, people who wear shoes that have poor ventilation and breathability, and people who are overweight tend to be more predisposed to developing toe jam between their toes.

which are areas of thickened skin on the feet, can contribute to the development of toe jam. Furthermore, Some skin conditions, such as eczema or psoriasis, are characterized by dry, flaking skin, which can accumulate between the t...

How to avoid and fix Ingrown Toenails?

An ingrown toenail may seem like a minor thing, but they sure hurt!

Things to do when your Toenail Is falling off

While losing a toenail is a common ailment for runners, it can happen to anyone and for a number of reasons. Here's how to make sure the new one arrives in good shape.

If your toenail is about to fall off, you're probably thinking "Help!" in sheer panic and making the same face as the "scream" emoji. But when it comes to losing one of these little guys, it pays to take a chill pill and wait.

Here's everything you need to know about the super-common issue of losing a toenail.






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