Gout – Treatment Guidelines

(BMJ)—A committee of experts w/ experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. The expert group developed 9 treat-to-target recommendations:

1. Serum urate must be measured regularly and urate-lowering tx should be adjusted to attain the therapeutic target.

2. Serum urate level <6 mg/dL should be targeted and maintained in all pts w/ gout.

3. In pts w/ severe gout, such as those w/ tophi or frequent attacks, urate target level should be <5 mg/dL until clinical remission is achieved.

4. Acute attacks should be treated promptly w/ anti-inflammatory meds, taking safety issues into consideration.

5. Prophylaxis against attacks should be initiated and continued for ≥6mo after starting urate-lowering tx.

6. In all pts w/ gout, renal function should be assessed at time of dx and then monitored regularly.

7. Comorbidities assoc w/ gout may influence tx and outcomes, and should be assessed regularly and managed.

8. Modifiable risk factors should be addressed primarily through pt education and support.

9. Info about gout and its mgmt should be made readily available to pts.

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