The 2022 NICE guidelines for the diagnosis and management of gout KeeleUniversity gout diagnosis healthcare medicine
By Suchandrima BhowmikMar 13 2023Reviewed by Benedette Cuffari, M.Sc. A new editorial study on Gout, Urate, and Crystal Deposition Disease discusses the 2022 National Institute for Health and Care Excellence guidelines for the management of gout.
Only a few people with gout receive the definitive ‘curative’ urate-lowering therapy . Of these individuals, some achieve target serum urate levels required for the dissolution of monosodium urate crystal and clinical remission. The highest profile disagreement between guideline recommendations concerning gout has been caused by the ACP ‘treat-to-avoid-symptoms’ approach to ULT. This approach differs from other national and international guidelines that include a ‘treat-to-target’ strategy, in which titration of the ULT dose is used to achieve target serum urate levels.
As compared to previously published guidelines regarding gout management, NICE recommends allopurinol or febuxostat as first-line ULT in people with gout without a history of major cardiovascular disease, while other guidelines recommended febuxostat only as a second-line ULT. NICE guidelines also concluded that no difference exists in cost-effectiveness or clinical efficacy between febuxostat and allopurinol.
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