What are the ACR guidelines for urate-lowering therapy in gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

ACR guidelines strongly recommend pharmacologic urate-lowering therapy for patients with gout who have 1 or more subcutaneous tophi on clinical examination, evidence of damage on an imaging study, or frequent attacks of acute gouty arthritis (2 or more attacks per year); once the target level has been achieved, uric acid should be monitored at 6-month intervals. [150]  The ACR conditionally recommends pharmacologic urate-lowering therapy for patients with chronic kidney disease of stage 3 or worse, a serum uric acid concentration > 9 mg/ dL, or urolithiasis. [127]


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