Clinical Quiz: Gout Flare Management Recommendations from 2020 ACR Guidelines

In recent years, gout has begun to grow into an overlooked public health crisis. According to national estimates, gout impacts approximately 4% of US adults and the prevalence more than doubled from the 1960s to the 1990s. Similar trends have been observed globally, with the most recent Global Burden of Disease Report projecting the global prevalence to reach 95.8 million in 2050.^1,2

Among the tenets of gout management is the prevention and treatment of gout flares. Characterized by periodic attacks of intense pain and swelling in your joints that can sometimes last for days or sometimes weeks, gout flares can contribute to permanent joint damage if left untreated. Additionally, data suggests a greater number of gout flares is associated with increased healthcare utilization, with a 2015 study demonstrating experiencing multiple gout flares per year was associated with a greater number of inpatient stays, emergency room visits, and ambulatory visits.^3,4

In 2020, the American College of Rheumatology (ACR) issued new guidance and recommendations for the management of gout. The 17-page document, which was the group's first new guideline on the topic since 2012, contained 42 recommendations, including 16 strong recommendations. In this clinical quiz, the second in a series of 4 based on the guideline, we test your knowledge on the management of gout flares.⁵

Check out other quizzes on the 2020 ACR gout guidelines:

Initiation and titration of urate-lowering therapy

References:

1. National Kidney Foundation. Quick facts: Gout and chronic kidney disease. National Kidney Foundation. August 19, 2024. Accessed August 25, 2024. https://www.kidney.org/kidney-topics/quick-facts-gout-and-chronic-kidney-disease.
2. GBD 2021 Gout Collaborators. Global, regional, and national burden of gout, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2024;6(8):e507-e517. doi:10.1016/S2665-9913(24)00117-6
3. National Institutes of Health. Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. June 21, 2024. Accessed August 25, 2024. https://www.niams.nih.gov/health-topics/gout.
4. Jackson R, Shiozawa A, Buysman EK, Altan A, Korrer S, Choi H. Flare frequency, healthcare resource utilisation and costs among patients with gout in a managed care setting: a retrospective medical claims-based analysis. BMJ Open. 2015;5(6):e007214. Published 2015 Jun 24. doi:10.1136/bmjopen-2014-007214
5. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout [published correction appears in Arthritis Care Res (Hoboken). 2020 Aug;72(8):1187. doi: 10.1002/acr.24401] [published correction appears in Arthritis Care Res (Hoboken). 2021 Mar;73(3):458. doi: 10.1002/acr.24566]. Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi:10.1002/acr.24180