This systematic review underpins the latest American College of Physicians (ACP) clinical practice guideline on the management of acute and recurrent gout, and highlights the following recommendations:
• That clinicians choose corticosteroids, NSAIDs, or colchicine to treat patients with acute gout. • That clinicians use low-dose colchicine when using colchicine to treat acute gout. • The ACP recommends against initiating long-term urate–lowering therapy in most patients after a first gout attack or in patients with infrequent attacks. • The ACP recommends that clinicians discuss benefits, harms, costs, and individual preferences with patients before initiating urate–lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks.
A systematic review on the diagnosis of gout together with guidance on the diagnosis of gout have also been published separately.