The management of gout involves treating pain and inflammation associated with acute flares and lowering the uric acid pool. A challenge associated with the successful management of gout is an increased risk of acute flares after initiation of urate-lowering therapy (ULT). Prophylactic anti-inflammatory therapy is recommended to prevent flares and foster compliance with urate lowering therapy.
The aim of our studies was to assess whether use of cherry juice concentrate is useful for gout flare prophylaxis. We report the results of three studies using cherry juice concentrate for gout prophylaxis. The first is a randomized controlled study comparing the use of cherry juice concentrate versus pomegranate juice concentrate for flare prophylaxis. The second is a retrospective study evaluating flare prophylaxis when cherry juice concentrate was taken over a 4 month period or longer. Lastly, a third study evaluating the effect of cherry juice concentrate compared with pomegranate juice concentrate on secretion of interleukins by human monocytes exposed to monosodium urate (MSU) crystals in vitro.
Ingesting cherry juice concentrate reduced the incidence of flares in gout patients regardless of whether or not they were treated with ULT. The number of flares was further reduced by cherry juice ingestion in patients receiving ULT than in patients not on ULT. We did not find a significant change in serum urate levels from baseline following intake of the cherry juice concentrate for 4 months or longer. Thus, cherry juice concentrate was most likely contributing to a reduction in flares via anti-inflammatory actions. We found cherry juice concentrate to inhibit in vitro secretion of IL-1β by up to 60%.
In conclusion, our studies suggest that, consumption of cherry juice concentrate for a period of 4 months or longer, reduces acute gout flares, via anti-inflammatory actions such as inhibition of IL-1β secretion. Large long-term randomized controlled trials are needed to further evaluate the usefulness of cherries and cherry juice concentrate for gout flare prophylaxis.