Clinical Question: To prevent gout recurrence, should we dose urate lowering therapies (like allopurinol) to target uric acid levels?
Bottom Line: Best evidence finds that increasing doses of allopurinol to achieve a specific serum urate target (example <360 μmol/L) does not reduce gout flares, pain, or function, compared to standard allopurinol dosing. Febuxostat increases cardiovascular and overall mortality and should not be used in most patients with gout.
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