Gout ⭐
gout · society: ACR · high-yield
Summary
The 2020 ACR Gout Management Guideline updates the 2012 version using GRADE methodology, providing 42 recommendations (16 strong) covering indications for urate-lowering therapy (ULT), ULT selection and titration, flare management, lifestyle, and concurrent medications. Key updates include allopurinol as preferred first-line ULT for all patients (including CKD stage ≥3), a strong endorsement of treat-to-target with serum urate <6 mg/dl, mandatory low-dose ULT initiation with concomitant anti-inflammatory prophylaxis for 3–6 months, and expanded ULT indications to include radiographic gout damage. Cost considerations and CVD safety signals with febuxostat now firmly position allopurinol over febuxostat as first-line.
Current guideline: ACR 2020 Gout Management Guideline · 
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Versions
- 2020 · ACR — ACR 2020 Gout Management Guideline