Management of Acute and Recurrent Gout
Authors: Russell P. Harris, Robert M. McLean, Amir Qaseem
Journal: Annals of Internal Medicine (2017)

Letters16 May 2017Management of Acute and Recurrent GoutRussell P. Harris, MD, MPH, Robert M. McLean, MD, and Amir Qaseem, MD, PhD, MHARussell P. Harris, MD, MPHFrom University of North Carolina School of Medicine, Chapel Hill, North Carolina; Yale School of Medicine, New Haven, Connecticut; American College of Physicians, Philadelphia, PA.Search for more papers by this author, Robert M. McLean, MDFrom University of North Carolina School of Medicine, Chapel Hill, North Carolina; Yale School of Medicine, New Haven, Connecticut; American College of Physicians, Philadelphia, PA.Search for more papers by this author, and Amir Qaseem, MD, PhD, MHAFrom University of North Carolina School of Medicine, Chapel Hill, North Carolina; Yale School of Medicine, New Haven, Connecticut; American College of Physicians, Philadelphia, PA.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0146 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Wagler and Pumerantz that clinicians need to manage gout effectively. The American College of Physicians' guidelines (1) were developed to meet the current standards for clinical guidelines set forth by the Guidelines International Network and Institute of Medicine (2, 3) and by using the best available evidence rather than relying on expert opinion. Although Drs. Wagler and Pumerantz advocate for a treat-to-target approach, evidence to support some of their statements about aggressive treatment, treating beyond clinical symptoms, or serum urate monitoring is currently insufficient. Kiltz and colleagues' article summarizing that the treat-to-target strategy is ...References1. Qaseem A, Harris RP, Forciea MA; Clinical Guidelines Committee of the American College of Physicians.. Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:58-68. [PMID: 27802508]. doi:10.7326/M16-0570 LinkGoogle Scholar2. Institute of Medicine.. Clinical Practice Guidelines We Can Trust. Washington, DC: National Academies Pr; 2011. Google Scholar3. Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P; Board of Trustees of the Guidelines International Network.. Guidelines International Network: toward international standards for clinical practice guidelines. Ann Intern Med. 2012;156:525-31. [PMID: 22473437]. doi:10.7326/0003-4819-156-7-201204030-00009 LinkGoogle Scholar4. Kiltz U, Smolen J, Bardin T, Cohen Solal A, Dalbeth N, Doherty M, et al. Treat-to-target (T2T) recommendations for gout. Ann Rheum Dis. 2016;76:632-8. [PMID: 27658678] doi:10.1136/annrheumdis-2016-209467 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of North Carolina School of Medicine, Chapel Hill, North Carolina; Yale School of Medicine, New Haven, Connecticut; American College of Physicians, Philadelphia, PA.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0570. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Russell P. Harris , Mary Ann Forciea , and Management of Acute and Recurrent Gout David Erk Management of Acute and Recurrent Gout Vanya D. Wagler and Aaron W. Pumerantz Metrics Cited byAngiotensin Receptor Blockers Effect on Serum Uric Acid—A Class Effect? 16 May 2017Volume 166, Issue 10Page: 760KeywordsDecision makingDisclosureGoutHematologic testsMotivationPatientsUric acid ePublished: 16 May 2017 Issue Published: 16 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...