Critical appraisal of serum urate targets in the management of gout

Nat Rev Rheumatol. 2022 Oct;18(10):603-609. doi: 10.1038/s41584-022-00816-1. Epub 2022 Aug 16.

Abstract

Gout management involves two broad aspects: treatment of gout flares to provide rapid symptomatic relief and long-term urate-lowering therapy to lower serum urate sufficiently to prevent gout flares from occurring. All of the major rheumatology societies recommend a target serum urate of <5 mg/dl (<0.30 mmol/l) or <6 mg/dl (<0.36 mmol/l), both of which are below the point of saturation for urate and therefore lead to monosodium urate crystal dissolution. In this Review, we describe the rationale for treat-to-target urate approach in the long-term management of gout and the current evidence and controversy around the appropriate serum urate targets.

Publication types

  • Review

MeSH terms

  • Gout Suppressants / therapeutic use
  • Gout* / drug therapy
  • Humans
  • Rheumatology*
  • Uric Acid

Substances

  • Gout Suppressants
  • Uric Acid