Gout: More Than Just a Painful Type of Arthritis
Gout affects 4-5% of adults in the United States, making it one of the most common forms of inflammatory arthritis. Yet it remains underdiagnosed and undertreated—and many people (including some doctors) still dismiss it as just a nuisance that affects the big toe occasionally.
Dr. Benjamin Plotz of UPMC is working to change that perception. In May 2025, he spoke with UPMC Physician Resources about creating one of the few dedicated gout clinics in the country and why gout deserves more attention.
Why Gout Matters More Than You Think
"Most patients—and even some physicians—see gout as just an intermittent problem, something that flares up, causes an acute painful arthritis in a joint, and then goes away," Dr. Plotz explains.
But gout is a chronic metabolic disease. When left untreated, it can cause:
- Severe joint damage in multiple joints
- Chronic pain between flares
- Increased risk of cardiovascular disease
The Cardiovascular Connection
Research has shown that after a gout flare, a person's risk of heart attack and stroke increases significantly for the next three months—particularly if they have other risk factors like diabetes, high cholesterol, or obesity.
"Gout is not just a joint disease—it is a systemic inflammatory condition with metabolic syndrome underpinnings," says Dr. Plotz.
Interestingly, colchicine, a traditional gout medication, has now been FDA-approved for cardiovascular disease prevention. Studies published in the New England Journal of Medicine have shown that colchicine reduces the risk of heart attacks in high-risk patients by about a third.
The Treatment Gap
Despite having effective medications, gout management remains suboptimal in the U.S.:
- Only about one-third of people with gout receive appropriate urate-lowering treatment
- Of those, less than half actually adhere to their prescribed regimen
One barrier is physician hesitancy to prescribe allopurinol (the first-line treatment) in patients with chronic kidney disease. Dr. Plotz notes that while hypersensitivity reactions are rare, the vast majority of patients can tolerate the medication well with appropriate dose adjustments.
What is a Dedicated Gout Clinic?
Dr. Plotz's clinic at UPMC focuses on:
- Patient education about the real consequences of untreated gout
- Long-term management (not just treating flares)
- Research and clinical trials for new treatments
- Accessibility—building stronger referral pathways from primary care
"Gout is a highly treatable disease if managed correctly," Dr. Plotz emphasizes. "With appropriate medication, lifestyle adjustments, and patient adherence, we can prevent flares, reduce complications, and significantly improve quality of life."
The Future of Gout Treatment
Work is ongoing to develop:
- New uric acid-lowering agents that work faster and more reliably
- New uses for existing drugs (like SGLT2 inhibitors for diabetes, which also lower uric acid)
But as Dr. Plotz notes: "Even if new therapies come online... there is still the need to address the underlying understanding of gout—the myths that have developed around it."
The Bottom Line
Gout isn't just about joint pain. It's a chronic condition with systemic implications. If you or someone you know has been dismissing gout flares as "no big deal," it might be time to see a specialist.
Source: UPMC Physician Resources. "Gout: More than Just a Painful Type of Arthritis." May 5, 2025. https://www.upmcphysicianresources.com/news/050525-gout
Dr. Benjamin Plotz is a rheumatologist at UPMC and the University of Pittsburgh School of Medicine. He is building one of the few dedicated gout clinics in the United States.