Table Info

Table 1.

Comparison of major societies’ gout guidelines

Guideline	2020 American College of Rheumatology (ACR) [9]	2016 European League Against Rheumatism (EULAR) [10]	2016 American College of Physicians (ACP) [11]
Discordant recommendations
ULT initiation (in patients with ≥ 2 flares/year)	Start ULT	Start ULT	Consider ULT
Target SU level	Target < 6 mg/dL	Target < 6 mg/dL, or less	No specific target; treat to manage symptoms
ULT titration	Titrate to target SU level	Titrate to target SU level	Titrate based on patient symptoms and side effects
First-line ULT	Allopurinol (start at ≤ 100 mg/day and titrate up)	Allopurinol (start at ≤ 100 mg/day and titrate up)	Allopurinol or febuxostat
Anti-inflammatory prophylaxis (during ULT initiation)	Low-dose colchicine, NSAIDs, or low-dose corticosteroids (3–6 months)	Low-dose colchicine or NSAIDs (6 months)	Low-dose colchicine or NSAIDs (> 8 weeks)
Concordant recommendations
Gout flare management	NSAIDs, colchicine, or corticosteroids	NSAIDs, colchicine, corticosteroids, or intra-articular steroids	NSAIDs, colchicine, or corticosteroids
Patient education	Emphasize lifestyle modifications, including dietary changes and weight loss	Emphasize lifestyle modifications, including dietary changes and weight loss	Emphasize lifestyle modifications, including dietary changes and weight loss
Lifestyle modifications	Recommend weight loss, reduced alcohol intake, and dietary changes	Recommend weight loss, reduced alcohol intake, and dietary changes	Recommend weight loss, reduced alcohol intake, and dietary changes

NSAIDs: non-steroidal anti-inflammatory drugs; SU: serum urate; ULT: urate lowering therapy

Declarations

Author contributions

ES: Investigation, Writing—original draft, Writing—review & editing. EMH: Investigation, Writing—original draft, Writing—review & editing. KGS: Conceptualization, Writing—review & editing, Supervision. All authors read and approved the submitted version.

Conflicts of interest

EMH and ES declare that they have no conflicts of interest. KGS reports research funding from Amgen, Arthrosi, Inventis-Bio, LG-Chem, and Olatec and consulting with Amgen, Atom, Crystalys, LG-chem, Shanton, and SOBI.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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