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Vitamin C does not lower uric acid levels in gout patients

Despite previous studies touting its benefit in moderating gout risk, new research reveals that vitamin C, also known ascorbic acid, does not reduce uric acid (urate) levels to a clinically significant degree in patients with established gout. Vitamin C supplementation, alone or in combination with allopurinol, appears to have a weak effect on lowering uric acid levels in gout patients according to the results published in the American College of Rheumatology (ACR) journal, Arthritis & Rheumatism.

Gout is an inflammatory arthritis that causes excruciating pain and swelling triggered by the crystallization of uric acid within the joints. Estimates from the ACR report that more than 8.3 million Americans suffer with gout. Medical evidence reports that long-term gout management requires treatment with medications that lower urate levels by inhibiting uric acid production (allopurinol) or increasing uric acid excretion (probenecid) through the kidneys.

"While current treatments are successful in reducing the amount of uric acid in the blood, there are many patients who fail to reach appropriate urate levels and need additional therapies," explains lead author, Prof. Lisa Stamp, from the University of Otago in Christchurch, New Zealand. "Vitamin supplementation is one such alternative therapy and the focus of our current study, which looked at the effects of vitamin C on urate levels in patients with gout."

The team recruited gout patients who had urate levels greater than the ACR treatment target level of 0.36 mmol/L (6 mg/100 mL). Of the 40 participants with gout, 20 patients already taking allopurinol were given an additional 500 mg dose of vitamin C daily or had the dose of allopurinol increased, while another 20 patients not already taking allopurinol were either started on allopurinol or vitamin C (500 mg/day). Researchers analyzed blood levels of vitamin C (ascorbate), creatinine and uric acid at baseline and week eight.

Study findings show that a modest vitamin C dose for eight weeks did not lower urate levels to a clinically significant degree in gout patients, but did increase ascorbate. The results differ from previous research which found that vitamin C reduced urate levels in healthy individuals without gout, but with high levels of uric acid (hyperuricemia). In fact, the Stamp et al. study found that reduction of uric acid was significantly less in gout patients taking vitamin C compared to those who started or increased their dose of allopurinol.

"Though vitamin C may reduce risk of developing gout, our data does not support using vitamin C as a therapy to lower uric acid levels in patients with established gout," concludes Prof. Stamp. "Further investigation of the urate lowering effects of a larger vitamin C dose in those with gout is warranted."

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May is Arthritis Awareness Month in the U.S. and October 12, 2013 is designated as World Arthritis Day.

This study is published in Arthritis & Rheumatism. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.

Full citation: "Clinically insignificant effect of supplemental vitamin C on serum urate in patients with gout; a pilot randomised controlled trial." Lisa K Stamp, John L O'Donnell, Christopher Frampton, Jill Drake, Mei Zhang and Peter T Chapman. Arthritis & Rheumatism; Published Online: May 16, 2013 (DOI: 10.1002/art.37925).

URL Upon Publication: http://doi.wiley.com/10.1002/art.37925

About the Author: To arrange an interview with Dr. Stamp, please contact Kim Thomas from the University of Otago at kim.thomas@otago.ac.nz.

About the Journal

Arthritis & Rheumatism is an official journal of the American College of Rheumatology (ACR) and covers all aspects of inflammatory disease. The American College of Rheumatology is the professional organization whose members share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers. The journal is published by Wiley on behalf of the ACR. For more information, please visit http://wileyonlinelibrary.com/journal/art.

About Wiley

Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's website can be accessed at http://www.wiley.com.

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