Gout: one year in review 2026

Area of Science:

• Rheumatology and Immunology
• Genetics and Precision Medicine
• Medical Informatics

Background:

• Gout understanding evolved significantly in 2025, shifting towards personalized medicine.
• Multidimensional pathogenetic models are increasingly central to gout research.
• A growing body of literature highlights advancements in gout management.

Purpose of the Study:

• To comprehensively review scientific literature on gout published in 2025.
• To highlight key advancements in epidemiology, diagnostics, genetics, and therapeutics.
• To analyze updated pathogenetic mechanisms and their therapeutic implications.

Main Methods:

• Systematic review of scientific literature published in 2025.
• Analysis of epidemiological trends, diagnostic imaging, and genetic studies.
• Evaluation of research on the gut-kidney axis, microbiome, immunometabolism, and therapeutic strategies.

Main Results:

• Rising incidence of early-onset gout noted, with genetic studies suggesting it as a distinct subset.
• Artificial intelligence integration into diagnostic imaging shows promise.
• New insights into the gut-kidney axis and microbiome's role in urate homeostasis were revealed.
• Updated pathogenetic mechanisms involving immunometabolic reprogramming were examined.

Conclusions:

• Gout management is increasingly personalized, integrating multidimensional pathogenetic insights.
• Early-onset gout and the gut-kidney axis represent significant areas for future research.
• Novel therapeutic strategies targeting immunometabolic pathways offer new hope for gouty arthritis and asymptomatic hyperuricemia.