Deep Dive — Evidence Details
References
- [1]
Shekelle PG, Newberry SJ, FitzGerald JD et al.. “Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline.” Annals of internal medicine (2016). PMID: 27802478 ↗
L2GUIDELINECited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [2]
Stamp L, Horne A, Mihov B et al.. “Is colchicine prophylaxis required with start-low go-slow allopurinol dose escalation in gout? A non-inferiority randomised double-blind placebo-controlled trial.” Annals of the rheumatic diseases (2023). PMID: 37652661 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [3]
Perez-Ruiz F, Sundy JS, Miner JN et al.. “Lesinurad in combination with allopurinol: results of a phase 2, randomised, double-blind study in patients with gout with an inadequate response to allopurinol.” Annals of the rheumatic diseases (2016). PMID: 26742777 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, Applicability and Caveats - [4]
Saag KG, Khanna PP, Keenan RT et al.. “A Randomized, Phase II Study Evaluating the Efficacy and Safety of Anakinra in the Treatment of Gout Flares.” Arthritis & rheumatology (Hoboken, N.J.) (2021). PMID: 33605029 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [5]
Barry A, Helget LN, Androsenko M et al.. “Comparison of Gout Flares With the Initiation of Treat-to-Target Allopurinol and Febuxostat: A Post-Hoc Analysis of a Randomized Multicenter Trial.” Arthritis & rheumatology (Hoboken, N.J.) (2024). PMID: 38925627 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [6]
Poiley J, Steinberg AS, Choi YJ et al.. “A Randomized, Double-Blind, Active- and Placebo-Controlled Efficacy and Safety Study of Arhalofenate for Reducing Flare in Patients With Gout.” Arthritis & rheumatology (Hoboken, N.J.) (2016). PMID: 26989892 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [7]
Terkeltaub R, Lee J, Min J et al.. “Serum Urate-Lowering Efficacy and Safety of Tigulixostat in Gout Patients With Hyperuricemia: A Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Trial.” Arthritis & rheumatology (Hoboken, N.J.) (2023). PMID: 36649008 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [8]
Maher D, Reeve E, Hopkins A et al.. “Comparative Risk of Gout Flares When Initiating or Escalating Various Urate-Lowering Therapy: A Systematic Review With Network Meta-Analysis.” Arthritis care & research (2024). PMID: 38303574 ↗
L2SR_OBSCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [9]
Zeng L, Qasim A, Neogi T et al.. “Efficacy and Safety of Pharmacologic Interventions in Patients Experiencing a Gout Flare: A Systematic Review and Network Meta-Analysis.” Arthritis care & research (2021). PMID: 32741131 ↗
L2SR_OBSCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [10]
Qaseem A, Harris RP, Forciea MA et al.. “Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians.” Annals of internal medicine (2016). PMID: 27802508 ↗
L2GUIDELINECited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [11]
Stamp LK, Frampton C, Stewart S et al.. “Relationship Between Gout Flare States and Patient-Reported Outcomes After Allopurinol Initiation.” Arthritis care & research (2025). PMID: 39748204 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [12]
Stamp LK, Horne A, Mihov B et al.. “Colchicine Concentrations and Relationship With Colchicine Efficacy and Adverse Events: Post Hoc Analysis of a Randomized Clinical Trial of Colchicine for Gout Flare Prophylaxis.” Arthritis care & research (2025). PMID: 40223442 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [13]
Stamp LK, Horne A, Mihov B et al.. “Predicting Gout Flares in People Starting Allopurinol Using the Start-Low Go-Slow Dose Escalation Strategy.” Arthritis care & research (2024). PMID: 38766703 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [14]
Pryymachenko Y, Wilson R, Dalbeth N et al.. “Cost-Effectiveness of Low-Dose Colchicine Prophylaxis When Starting Allopurinol Using the "Start-Low Go-Slow" Approach for Gout: Evidence From a Noninferiority Randomized Double-Blind Placebo-Controlled Trial.” Arthritis care & research (2025). PMID: 40827007 ↗
L1RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [15]
Roddy E, Clarkson K, Blagojevic-Bucknall M et al.. “Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care.” Annals of the rheumatic diseases (2019). PMID: 31666237 ↗
L2TRIAL_NONRANDOMCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [16]
Russell MD, Clarke BD, Roddy E et al.. “Improving outcomes for patients hospitalized with gout: a systematic review.” Rheumatology (Oxford, England) (2021). PMID: 34247233 ↗
L2SR_OBSCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [17]
Banerjee M, Pal R, Maisnam I et al.. “Serum uric acid lowering and effects of sodium-glucose cotransporter-2 inhibitors on gout: A meta-analysis and meta-regression of randomized controlled trials.” Diabetes, obesity & metabolism (2023). PMID: 37334516 ↗
L1SR_MA_RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [18]
Yu J, Lu H, Zhou J et al.. “Oral prednisolone versus non-steroidal anti-inflammatory drugs in the treatment of acute gout: a meta-analysis of randomized controlled trials.” Inflammopharmacology (2018). PMID: 29357007 ↗
L1SR_MA_RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [19]
Billy CA, Lim RT, Ruospo M et al.. “Corticosteroid or Nonsteroidal Antiinflammatory Drugs for the Treatment of Acute Gout: A Systematic Review of Randomized Controlled Trials.” The Journal of rheumatology (2017). PMID: 28765243 ↗
L1SR_MA_RCTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [20]
Scheepers LEJM, Burden AM, Arts ICW et al.. “Medication adherence among gout patients initiated allopurinol: a retrospective cohort study in the Clinical Practice Research Datalink (CPRD).” Rheumatology (Oxford, England) (2018). PMID: 29893941 ↗
L3COHORTCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, Applicability and Caveats - [21]
Kim HW, Joo YS, Yun HR et al.. “Colchicine use and the risk of CKD progression: a multicentre nested case-control study.” Rheumatology (Oxford, England) (2022). PMID: 35139160 ↗
L3CASE_CONTROLCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [22]
Robinson PC, Dalbeth N, Donovan P. “Cost-Effectiveness of Colchicine Prophylaxis for Gout Flares When Commencing Allopurinol.” Arthritis care & research (2021). PMID: 32558298 ↗
L5OTHERCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [23]
Kwok TSH, Kuriya B, Hawker G et al.. “Adherence and Treat-to-Target Benchmarks in Older Adults With Gout Initiating Urate-Lowering Therapy in Ontario, Canada: A Population-Based Study.” Arthritis care & research (2024). PMID: 38831665 ↗
L5OTHERCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [24]
Zhou X, Peng S, Hu L et al.. “Meridian-Sinew Release Therapy as an adjunctive treatment for gouty arthritis: a systematic review and meta-analysis.” Journal of orthopaedic surgery and research (2025). PMID: 40826358 ↗
L2SR_OBSCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard, On the Horizon - [25]
Butt JH, Docherty KF, Claggett BL et al.. “Association of Dapagliflozin Use With Clinical Outcomes and the Introduction of Uric Acid-Lowering Therapy and Colchicine in Patients With Heart Failure With and Without Gout: A Patient-Level Pooled Meta-analysis of DAPA-HF and DELIVER.” JAMA cardiology (2023). PMID: 36811901 ↗
L2SR_OBSCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [26]
Parperis K, Papachristodoulou E, Kakoullis L et al.. “Management of calcium pyrophosphate crystal deposition disease: A systematic review.” Seminars in arthritis and rheumatism (2020). PMID: 33360232 ↗
L2SR_OBSCited in: Bottom Line, Current Evidence and Standard - [27]
Janssen CA, Oude Voshaar MAH, Vonkeman HE et al.. “Anakinra for the treatment of acute gout flares: a randomized, double-blind, placebo-controlled, active-comparator, non-inferiority trial.” Rheumatology (Oxford, England) (2019). PMID: 30602035 ↗
L5OTHERCited in: Bottom Line, Background: Evolution of Treatment, Current Evidence and Standard - [28]
Zhang W, Doherty M, Bardin T et al.. “EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT).” Annals of the rheumatic diseases (2006). PMID: 16707532 ↗
L2GUIDELINECited in: Background: Evolution of Treatment - [29]
Schlesinger N, Alten RE, Bardin T et al.. “Canakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensions.” Annals of the rheumatic diseases (2012). PMID: 22586173 ↗
L1RCTCited in: Background: Evolution of Treatment - [30]
Schlesinger N, Mysler E, Lin HY et al.. “Canakinumab reduces the risk of acute gouty arthritis flares during initiation of allopurinol treatment: results of a double-blind, randomised study.” Annals of the rheumatic diseases (2011). PMID: 21540198 ↗
L1RCTCited in: Background: Evolution of Treatment - [31]
Janssens HJ, Janssen M, van de Lisdonk EH et al.. “Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomised equivalence trial.” Lancet (London, England) (2008). PMID: 18514729 ↗
L1RCTCited in: Background: Evolution of Treatment - [32]
Sutaria S, Katbamna R, Underwood M. “Effectiveness of interventions for the treatment of acute and prevention of recurrent gout--a systematic review.” Rheumatology (Oxford, England) (2006). PMID: 16632483 ↗
L2SR_OBSCited in: Background: Evolution of Treatment - [33]
Singh JA, Hodges JS, Asch SM. “Opportunities for improving medication use and monitoring in gout.” Annals of the rheumatic diseases (2008). PMID: 18701554 ↗
L5OTHERCited in: Background: Evolution of Treatment - [34]
Janssens HJ, Lucassen PL, Van de Laar FA et al.. “Systemic corticosteroids for acute gout.” The Cochrane database of systematic reviews (2008). PMID: 18425920 ↗
L2SR_OBSCited in: Background: Evolution of Treatment - [35]
Perez-Ruiz F. “Treating to target: a strategy to cure gout.” Rheumatology (Oxford, England) (2009). PMID: 19447780 ↗
L5REVIEW_NARRATIVECited in: Background: Evolution of Treatment - [36]
Khanna PP, Perez-Ruiz F, Maranian P et al.. “Long-term therapy for chronic gout results in clinically important improvements in the health-related quality of life: short form-36 is responsive to change in chronic gout.” Rheumatology (Oxford, England) (2010). PMID: 21147824 ↗
L5OTHERCited in: Background: Evolution of Treatment - [37]
Bajpai R, Partington R, Muller S et al.. “Prognostic factors for colchicine prophylaxis-related adverse events when initiating allopurinol for gout: retrospective cohort study.” Rheumatology (Oxford, England) (2025). PMID: 38636489 ↗
L3COHORTCited in: Applicability and Caveats - [38]
Lu J, He Y, Terkeltaub R et al.. “Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination.” Annals of the rheumatic diseases (2022). PMID: 35277390 ↗
L5OTHERCited in: Applicability and Caveats - [39]
McKenzie BJ, Wechalekar MD, Johnston RV et al.. “Colchicine for acute gout.” The Cochrane database of systematic reviews (2021). PMID: 34438469 ↗
L2SR_OBSCited in: Applicability and Caveats - [40]
Kim HW, Kang M, Lim H et al.. “Association between colchicine use and adverse cardiovascular events in patients with gout: a nationwide nested case-control study.” Rheumatology (Oxford, England) (2025). PMID: 39392785 ↗
L3CASE_CONTROLCited in: Applicability and Caveats - [41]
Bowen-Davies Z, Muller S, Mallen CD et al.. “Gout Severity, Socioeconomic Status, and Work Absence: A Cross-Sectional Study in Primary Care.” Arthritis care & research (2018). PMID: 29579363 ↗
L5OTHERCited in: Applicability and Caveats - [42]
Kwok TSH, Kuriya B, Hawker G et al.. “Serum Urate Monitoring Among Older Adults With Gout: Initiating Urate-Lowering Therapy in Ontario, Canada.” Arthritis care & research (2023). PMID: 37248652 ↗
L5OTHERCited in: Applicability and Caveats - [43]
Toprover M, Shah B, Oh C et al.. “Initiating guideline-concordant gout treatment improves arterial endothelial function and reduces intercritical inflammation: a prospective observational study.” Arthritis research & therapy (2020). PMID: 32653044 ↗
L5OTHERCited in: Applicability and Caveats - [44]
Liu J, Gamble GD, Dalbeth N. “Are participants in gout medication registration clinical trials representative of people with gout in the general population?” Seminars in arthritis and rheumatism (2025). PMID: 39919487 ↗
L2TRIAL_NONRANDOMCited in: Applicability and Caveats - [45]
Richter A, Truthmann J, Hummers E et al.. “Prednisolone Versus Colchicine for Acute Gout in Primary Care: statistical analysis plan for the pragmatic, multicenter, randomized, and double-blinded COPAGO non-inferiority trial.” Trials (2024). PMID: 38570873 ↗
L1RCTCited in: Applicability and Caveats - [46]
Pascart T, Lioté F. “Gout: state of the art after a decade of developments.” Rheumatology (Oxford, England) (2019). PMID: 29547895 ↗
L5REVIEW_NARRATIVECited in: Applicability and Caveats - [47]
Latourte A, Pascart T, Flipo RM et al.. “2020 Recommendations from the French Society of Rheumatology for the management of gout: Management of acute flares.” Joint bone spine (2020). PMID: 32422339 ↗
L5OTHERCited in: Applicability and Caveats - [48]
Oka P, Chong WM, Ng DX et al.. “Epidemiology and risk factors associated with gout control among adult Asians: a real-world retrospective cohort study.” Frontiers in medicine (2023). PMID: 37746085 ↗
L3COHORTCited in: Applicability and Caveats - [49]
Chuang JP, Lee JC, Leu TH et al.. “Association of gout and colorectal cancer in Taiwan: a nationwide population-based cohort study.” BMJ open (2019). PMID: 31601586 ↗
L3COHORTCited in: Applicability and Caveats - [50]
Truthmann J, Freyer Martins Pereira J, Richter A et al.. “Prednisolone Versus Colchicine for Acute Gout in Primary Care (COPAGO): protocol for a two-arm multicentre, pragmatic, prospective, randomized, double-blind, controlled clinical trial of prednisolone and colchicine for non-inferiority with a parallel group design.” Trials (2023). PMID: 37798801 ↗
L2TRIAL_NONRANDOMCited in: Applicability and Caveats - [51]
Walsh CP, Prior JA, Chandratre P et al.. “Illness perceptions of gout patients and the use of allopurinol in primary care: baseline findings from a prospective cohort study.” BMC musculoskeletal disorders (2016). PMID: 27639692 ↗
L3COHORTCited in: Applicability and Caveats - [52]
Sun J, Wang Y, Cheng Y et al.. “Efficacy and Safety of Dotinurad Versus Febuxostat for the Treatment of Gout: A Randomized, Multicenter, Double-Blind, Phase 3 Trial in China.” Arthritis & rheumatology (Hoboken, N.J.) (2025). PMID: 40417858 ↗
L1RCTCited in: On the Horizon - [53]
Botson JK, Saag K, Peterson J et al.. “A Randomized, Placebo-Controlled Study of Methotrexate to Increase Response Rates in Patients with Uncontrolled Gout Receiving Pegloticase: Primary Efficacy and Safety Findings.” Arthritis & rheumatology (Hoboken, N.J.) (2022). PMID: 36099211 ↗
L1RCTCited in: On the Horizon - [54]
Helget LN, O'Dell JR, Newcomb JA et al.. “Determinants of Achieving Serum Urate Goal with Treat-to-Target Urate-Lowering Therapy in Gout.” Arthritis & rheumatology (Hoboken, N.J.) (2023). PMID: 37842953 ↗
L1RCTCited in: On the Horizon - [55]
Barry A, England BR, Sayles H et al.. “Improvements in Health-Related Quality of Life With Treat-to-Target Urate-Lowering Therapy in Gout: A Post Hoc Analysis of a Randomized Multicenter Trial.” Arthritis care & research (2025). PMID: 40771143 ↗
L1RCTCited in: On the Horizon - [56]
Tabi-Amponsah AD, Stewart S, Gamble G et al.. “Time Trends and Predictors of Gout Remission Over 6 Years.” Arthritis care & research (2025). PMID: 40528737 ↗
L1RCTCited in: On the Horizon - [57]
Murdoch R, Mihov B, Horne AM et al.. “Impact of Television Depictions of Gout on Perceptions of Illness: A Randomized Controlled Trial.” Arthritis care & research (2023). PMID: 37038965 ↗
L1RCTCited in: On the Horizon - [58]
Baraf HSB, Khanna PP, Kivitz AJ et al.. “The COMPARE head-to-head, randomized controlled trial of SEL-212 (pegadricase plus rapamycin-containing nanoparticle, ImmTOR™) versus pegloticase for refractory gout.” Rheumatology (Oxford, England) (2024). PMID: 37449908 ↗
L1RCTCited in: On the Horizon - [59]
Selvadurai D, Coleshill MJ, Day RO et al.. “Patient factors and health outcomes associated with illness perceptions in people with gout.” Rheumatology (Oxford, England) (2024). PMID: 37769230 ↗
L1RCTCited in: On the Horizon - [60]
Cao C, Gamble G, Horne A et al.. “The Tophus Impact Questionnaire (TIQ-20): responsiveness to change during urate-lowering therapy.” Rheumatology (Oxford, England) (2024). PMID: 37688559 ↗
L1RCTCited in: On the Horizon - [61]
Wang C, Guo K, Dalbeth N et al.. “Impact of adding urine alkalization therapy to xanthine oxidase inhibitor in gout management: a prospective cohort study.” Rheumatology (Oxford, England) (2025). PMID: 39932882 ↗
L2TRIAL_NONRANDOMCited in: On the Horizon - [62]
Cheng Z, Xu X, Qi H et al.. “Obesity reduces the urate-lowering efficacy among patients with primary gout: a prospective cohort study.” Rheumatology (Oxford, England) (2025). PMID: 39928353 ↗
L2TRIAL_NONRANDOMCited in: On the Horizon - [63]
Troum OM, Duong M, Obermeyer K et al.. “Treatment-emergent major adverse cardiovascular and thromboembolic events were infrequent during clinical trials of pegloticase.” Rheumatology (Oxford, England) (2025). PMID: 39792028 ↗
L2TRIAL_NONRANDOMCited in: On the Horizon - [64]
Hammer HB, Karoliussen L, Terslev L et al.. “Ultrasound-detected crystal depositions and clinical flares dissolve during successful urate-lowering therapy: 5-year follow-up results from the treat-to-target NOR-Gout study.” Annals of the rheumatic diseases (2025). PMID: 41271521 ↗
L5OTHERCited in: On the Horizon - [65]
Christensen R, Zobbe K, Nielsen SM et al.. “Weight Loss for Patients With Gout and Concomitant Obesity: A Proof-of-Concept Randomized Trial.” Arthritis & rheumatology (Hoboken, N.J.) (2024). PMID: 38169151 ↗
L5OTHERCited in: On the Horizon - [66]
Rasmussen C, Larsen JW, Christensen HM et al.. “Optimising gout treatment: insights from a nurse-led cohort study.” RMD open (2024). PMID: 38663881 ↗
L3COHORTCited in: On the Horizon - [67]
Zhao X, Fan Y, Sun J et al.. “Efficacy and safety of Chinese herbal compound in the treatment of acute gouty arthritis: A systematic review and meta-analysis of randomized controlled trials.” International immunopharmacology (2025). PMID: 39923577 ↗
L1SR_MA_RCTCited in: On the Horizon - [68]
Cai Z, Lv Y, Liu Y et al.. “Quantitative evaluation of clinical efficacy and safety of uric acid-lowering drugs: A modeling analysis of literature aggregate data.” Seminars in arthritis and rheumatism (2025). PMID: 40780110 ↗
L2SR_OBSCited in: On the Horizon - [69]
Bogoviku J, Nguyen TD, Westphal JG et al.. “Effects of empagliflozin on uric acid levels during acute heart failure recompensation: A sub-analysis of the EMPAG-HF trial (Effects of Empagliflozin on Diuresis and Renal Function in Patients with Acute Decompensated Heart Failure).” European journal of heart failure (2025). PMID: 40631522 ↗
L1RCTCited in: On the Horizon - [70]
Jun JB, Lee HS, Kim SH et al.. “Efficacy and safety of epaminurad, a potent hURAT1 inhibitor, in patients with gout: a randomized, placebo-controlled, dose-finding study.” Arthritis research & therapy (2025). PMID: 40420308 ↗
L1RCTCited in: On the Horizon - [71]
Uhlig T, Karoliussen LF, Sexton J et al.. “Non-adherence to urate lowering therapy in gout after 5 years is related to poor outcomes: results from the NOR-Gout study.” Rheumatology (Oxford, England) (2025). PMID: 39292608 ↗
L5OTHERCited in: On the Horizon - [72]
Bartsch V, Standfest K, Hueber A. “[Gout : From the diagnosis to guideline-based treatment].” Zeitschrift fur Gerontologie und Geriatrie (2025). PMID: 39998560 ↗
L5OTHERCited in: On the Horizon
