08 June 2023

In our new Talking Rheumatology podcast episode, Dr Marwan Bukhari, editor in chief for Rheumatology, interviews consultant rheumatologists Edward Roddy and Kelsey Jordan to explore gout guidelines, what’s new and what changes are needed.

Despite numerous national and international guidelines for gout (EULAR, ACR, and our 2017 BSR guideline) there is poor uptake of urate-lowering therapies and there is a need to move towards a treat-to-target principle.

The NICE guideline for the diagnosis and management of gout provides evidence-based recommendations for health professionals, patients and commissioning bodies. It is also easy to read for lay people and non-medical professionals.

In the podcast episode, Edward Roddy and Kelsey Jordan highlight the key take-home messages to support better outcomes for people with gout:

  • Febuxostat or allopurinol can be offered in equal weighting as a first-line treatment.
  • The recommended target serum urate level is below 360 micromol/litre, in line with both EULAR and ACR guidelines.
  • The treat-to-target approach has been more strongly advocated.
  • There is more emphasis on patient empowerment and discussion about the use of urate-lowering treatments at diagnosis.
  • Follow-up with patients longer term with an annual assessment of urate.

Edward Roddy explains, “We need a paradigm shift away from viewing gout as a self-inflicted condition because of lifestyle habits, and a shift away from the management of inflammatory manifestations of gout, and focus instead on urate-lowering therapy.”

Listen to the podcast for free here.

Read the full NICE guideline for gout here.

Find all the latest clinical guidelines from the British Society for Rheumatology here.