Can gout management guidelines be solely evidence based?

The ACR has published an update to its guideline on gout management, which was mostly based on the results of randomized controlled trials (RCTs). Although rigorous, the methodology used for

these recommendations can be called into questioned given the lack of robust data from RCTs on all aspects of gout. Access through your institution Buy or subscribe This is a preview of

subscription content, access via your institution ACCESS OPTIONS Access through your institution Access Nature and 54 other Nature Portfolio journals Get Nature+, our best-value

online-access subscription $29.99 / 30 days cancel any time Learn more Subscribe to this journal Receive 12 print issues and online access $209.00 per year only $17.42 per issue Learn more

Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS:

* Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Kuo, C. F. et al. Global epidemiology of gout: prevalence, incidence and risk

factors. _Nat. Rev. Rheumatol._ 11, 649–662 (2015). Article  Google Scholar  * Richette, P. et al. 2016 updated EULAR evidence-based recommendations for the management of gout. _Ann. Rheum.

Dis._ 76, 29–42 (2017). Article  CAS  Google Scholar  * Pascart, T. et al. 2020 recommendations from the French Society of Rheumatology for the management of gout: urate-lowering therapy.

_Joint Bone Spine_ https://doi.org/10.1016/j.jbspin.2020.05.002 (2020). Article  PubMed  Google Scholar  * FitzGerald, J. D. et al. 2020 American College of Rheumatology guideline for the

management of gout. _Arthritis Rheumatol._ 72, 879–895 (2020). Article  Google Scholar  * Sheridan, D. J. & Julian, D. G. Achievements and limitations of evidence-based medicine. _J. Am.

Col. Cardiol._ 68, 204–213 (2016). Article  Google Scholar  * Dalbeth, N. et al. Discordant American College of Physicians and international rheumatology guidelines for gout management:

consensus statement of the Gout, Hyperuricemia and Crystal- Associated Disease Network (G-CAN). _Nat. Rev. Rheumatol._ 13, 561–568 (2017). Article  Google Scholar  * Richette, P. et al.

Response: Renal dosing of allopurinol results in suboptimal gout care by T. Neogi et al. _Ann. Rheum. Dis._ 76, e2 (2017). Article  Google Scholar  * White, W. B. et al. Cardiovascular

safety of febuxostat or allopurinol in patients with gout. _N. Engl. J. Med._ 378, 1200–1210 (2018). Article  CAS  Google Scholar  * Ghang, B. et al. Discontinuing febuxostat might cause

more deaths than continuing febuxostat: the untold story from the CARES trial. _Rheumatology_ 59, 1439–1440 (2020). Article  Google Scholar  * MacDonald, T. M. et al. Protocol of the

Febuxostat versus Allopurinol Streamlined Trial (FAST): a large prospective, randomised, open, blinded endpoint study comparing the cardiovascular safety of allopurinol and febuxostat in the

management of symptomatic hyperuricaemia. _BMJ Open_ 4, e005354 (2014). Article  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of

Rheumatology, Hôpital Lariboisière, Paris, France Thomas Bardin & Pascal Richette * Université de Paris INSERM Unit U1132, Paris, France Thomas Bardin & Pascal Richette Authors *

Thomas Bardin View author publications You can also search for this author inPubMed Google Scholar * Pascal Richette View author publications You can also search for this author inPubMed 

Google Scholar CORRESPONDING AUTHOR Correspondence to Thomas Bardin. ETHICS DECLARATIONS COMPETING INTERESTS T.B. declares that he has received advisory fees from AstraZeneca, Grunenthal and

Novartis, and educational presentation fees from Astellas, Grunenthal and Novartis. P.R. declares that he has received fees from AstraZeneca, Ipsen Pharma/Menarini and Savient. RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Bardin, T., Richette, P. Can gout management guidelines be solely evidence based?. _Nat Rev Rheumatol_ 16, 479–480

(2020). https://doi.org/10.1038/s41584-020-0471-8 Download citation * Published: 20 July 2020 * Issue Date: September 2020 * DOI: https://doi.org/10.1038/s41584-020-0471-8 SHARE THIS ARTICLE

Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard

Provided by the Springer Nature SharedIt content-sharing initiative