Gout

Gout is a type of inflammatory arthritis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases explains that it causes pain and swelling in the joints, usually as flares that last a week or two and then resolve, and that flares often begin in the big toe or a lower limb. Gout happens when high levels of urate (uric acid) build up in the body over time and form needle-shaped crystals in and around a joint.

Risk factors include genetics, being male, obesity, kidney disease, high blood pressure, heavy alcohol use, a diet high in certain meats and seafood, and some medications such as diuretics. Treatment focuses on calming flares and, for people with frequent attacks, long-term drugs that lower uric acid, such as allopurinol and febuxostat.

Gout medications have been the subject of safety actions and lawsuits. In February 2019, the FDA added a boxed warning to febuxostat (Uloric) after a safety trial found a higher rate of cardiovascular death in gout patients with established heart disease compared with allopurinol, and it limited Uloric to patients who cannot use allopurinol. Lawsuits followed, alleging the manufacturer knew about the heart risks earlier; the company denied the claims. Separately, allopurinol is one of the drugs most often associated with severe skin reactions such as Stevens-Johnson syndrome and DRESS, which can lead to individual injury claims.

If you took a gout drug and suffered a heart attack, stroke, or severe skin reaction, keep your prescription records and hospital records, and do not stop a prescribed drug without talking to your doctor. Our black box warning entry and mass tort guide explain how these cases are built.