Clinical Practice Guideline

Management of Acute and Recurrent Gout

Management of Acute and Recurrent Gout

(Endorsed, April 2017)

The guideline, Management of Acute and Recurrent Gout, was developed by the American College of Physicians and was endorsed by the American Academy of Family Physicians. 

Key Recommendations

  • Corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or low-dose colchicine should be prescribed for patients who have acute gout.
  • Long-term urate-lowering therapy should not be initiated in most patients after their first gout attack or in patients who have infrequent gout attacks. 
  • A discussion of the benefits, harms, costs, and individual preferences should be held with patients who have recurrent gout attacks before initiating urate-lowering therapy and concomitant prophylaxis.

These guidelines are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute the individual judgment brought to each clinical situation by the patient’s family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These guidelines are only one element in the complex process of improving the health of America. To be effective, the guidelines must be implemented.