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TFP #262 – Who let the Gout Out? Targeting Uric Acid Levels in Treating Gout

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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