Clinical Quiz: Urate-Lowering Therapy Recommendations from 2020 ACR Gout Guidelines

Characterized by painful arthritis and a significant impact on patients' quality of life, gout represents a significant threat to the quality of life for patients. With the number of rheumatologists declining and the rising prevalence of gout expected to continue, it also represents a considerable public health burden in the coming decades.

According to recent 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. A cornerstone in the management of gout flares, optimal use of urate-lowering therapy stands to have meaningful benefits on clinical outcomes, healthcare utilization, and quality of life for patients with gout.

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 first in a series of 4 based on the guideline, we test your knowledge on 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. 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