EULAR Recommends Treatment for Acute Gout at "First Warning"

Gout should never be neglected, says Pascal Richette, M.D., Ph.D., the French physician who led the development of the 2016 EULAR treatment guidelines for gout. In a systemic review of studies published since 2006, EULAR lists 11 new treatment guidelines. The guidelines differ from the 2012 ACR treatment guidelines for gout in some ways:  While the ACR recommends allopurinol or febuxostat as first-line therapy, EULAR recommends allopurinol first and then febuxostat when allopurinol fails to reach SUA targets. Also, EULAR recommends adjusting the allopurinol dosage to the creatinine clearance in patients with renal failure due to the increased risk of SCARs in those patients (febuxostat is recommended as an alternative if the SUA target is not reached). And, while the ACR recommends ULTs for acute attacks when anti-inflammatory treatments have been introduced, EULAR does not. (Full coverage of the EULAR gout guidelines on Rheumatology Network.)

References:

P Richette, M Doherty, et al. 

"2016 updated EULAR evidence-based recommendations for the management of gout," 

Annals of the Rheumatic Diseases.

July 25, 2016.  DOI:10.1136/annrheumdis-2016-209707