Purpose of review
This review discusses the findings of recently published translational research studies that have the potential to directly impact on the management of gout
Recent research suggests that treat-to-target urate-lowering treatment
(ULT) alongside individualized education about gout
, and shared decision making results in excellent adherence with ULT and prevents gout
flares in the long term. Such interventions should preferentially be delivered face-to-face rather than remotely. The recently published CARES study raises the possibility that febuxostat increases the risk of death in people with preexisting major cardiovascular diseases, and, allopurinol
should remain the first-choice ULT. There is paucity of data on the dosing of ULT for managing hyperuricaemia in gout
patients with chronic kidney disease
. However, recent research suggests that the dose of allopurinol
can be gradually increased to above the conventional renal dose in people with chronic kidney disease
hypersensitivity syndrome. However, additional larger studies are needed in this field.
In summary, long-term treat-to-target ULT prevents gout
flares and improves quality of life. Given the recent safety concerns, gradually up-titrated allopurinol
remains the first-line urate-lowering drug.