Clinical recommendation	Evidence rating	Comments
Lifestyle modifications to prevent recurrent gout include reducing the consumption of high-fructose soft drinks, fruit juices, fruits, and purine-rich foods (e.g., anchovies, sardines, scallops, mussels, bacon, beef, liver, turkey, veal, venison).14	C	Systematic review of mostly observational studies
A validated clinical prediction rule (Table 3) should be used to determine the likelihood of gout based on the presence of typical signs and symptoms and the uric acid level.17	C	Limited quality, patient-oriented evidence, individual validation trial
Nonsteroidal anti-inflammatory drugs and corticosteroids are equally effective for the treatment of acute gout, with no significant difference in pain relief or adverse effects.34	B	Limited quality, patient-oriented evidence, individual randomized controlled trial
In acute gout, low-dose colchicine (1.2 mg followed by 0.6 mg in 1 hour) is as effective as high-dose colchicine (1.2 mg followed by 0.6 mg every hour for 6 hours) with fewer adverse effects.35	B	Limited-quality, patient-oriented evidence, individual randomized controlled trial
Allopurinol is the preferred first-line urate-lowering therapy to prevent recurrent gout. It is as effective as febuxostat (Uloric) in preventing gout flare-ups; however, febuxostat increases all-cause and cardiovascular mortality.41,42	A	Good-quality, patient-oriented evidence, individual randomized controlled trial
The allopurinol hypersensitivity assay, or HLA-B*58:01 test, should be considered in select patients (Korean adults with stage 3 or higher chronic kidney disease and all adults of Han or Thai descent) before initiating allopurinol therapy.44	C	Expert opinion, consensus guideline