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What changes in the management of gout?
  1. James A Cave, Editor-in-Chief
  1. The Downland Practice, Berkshire, UK
  1. Correspondence to Dr James A Cave, The Downland Practice, Berkshire, UK; jcave{at}

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In June, the National Institute for Health and Care Excellence (NICE) published its guideline on the management of gout.1 This was timely coming shortly after The Lancet published a paper that criticised the state of gout management in the UK.2 Using the UK Clinical Practice Research Datalink database, the authors of The Lancet paper reviewed primary care data on people with gout and, in particular, whether the use of urate-lowering therapy (ULT) had changed since publication in 2016 and 2017 of European and British guidelines on the management of gout.3 4 Both sets of guidelines advised that everyone should be offered ULT following an acute episode of gout with a strategy of treating to a target urate level. The analysis of people with newly diagnosed gout found that in 2020 around a third were started on ULT within a year of diagnosis, a little over a third then achieved a target urate level of ≤360 µmol/L and around a fifth received treat-to-target urate monitoring.2 Although the …

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