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

Area of Science:

• Rheumatology
• Clinical Pharmacology
• Epidemiology

Background:

• Significant advancements in gout pharmacotherapy and evidence have emerged since 2006.
• The European League Against Rheumatism (EULAR) identified the need for updated gout management recommendations.

Purpose of the Study:

• To systematically review and update the 2006 EULAR recommendations for gout management.
• To provide evidence-based guidance on non-pharmacological and pharmacological gout treatments.

Main Methods:

• A systematic literature review was conducted by a multidisciplinary EULAR task force.
• Recommendations were formulated using a Delphi consensus approach involving 15 rheumatologists, general practitioners, patients, and methodologists.

Main Results:

• Eleven key recommendations and three overarching principles were established.
• Flare management includes colchicine, NSAIDs, or steroids; IL-1 blockers for refractory cases.
• Urate-lowering therapy (ULT) is recommended from initial presentation, targeting serum uric acid (SUA) <6 mg/dL (<360 µmol/L) or <5 mg/dL (<300 µmol/L) for severe gout.

Conclusions:

• The updated recommendations aim to optimize gout treatment strategies.
• Physicians and patients are informed on achieving predefined urate targets for disease remission.