Background New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of th…

A most noteworthy “new recommendation” different from the ACR one is this:

urate-lowering therapy (ULT) should be considered from the first presentation of the disease“.

Yes. Effectively lifelong treatment from the first flare. Because we are increasingly aware of the dire consequences of hyperuricaemia to renal and cardiovascular health. And hyperuricaemia is a lifestyle inflammatory metabolic disorder, like diabetes and obesity, that is not going to spontaneously remit.

New EULAR gout guidelines garner praise, criticism

Dr. John FitzGeraldDr. N. Lawrence Edwards
The European League Against Rheumatism’s updated recommendations on gout generally resemble those from the American College of Rheumatology, but with several important caveats, two prominent U.S. rheumatologists said in interviews. First came the praise. “Both ACR and EULAR are sending a consistent…
rheumatologynews.com|By AMY KARON

EULAR Updates Gout Guidelines

A EULAR task force of 24 individuals (including 15 rheumatologists) have updated their previous 2006 guidelines for gout.  The current update is based on a systematic literature review and a Delphi consensus approach to recommendations.

Br J Nutr. 2016 Mar 14;115(5):800-6. doi: 10.1017/S0007114515005310. Epub 2016 Jan 20. Randomized Controlled Trial; Research Support, Non-U.S. Gov’t
ncbi.nlm.nih.gov|By Shi Y and Williamson G

For those more inclined towards more “natural” remedies, Quercetin may be of interest. However, effects are modest: 100g of red onions a day lowers serum uric acid by an average of 8%. This is unlikely to help anyone with Gout to achieve target serum uric acid level of below 6 mg% (360 umol/L).

Obese patients who underwent bariatric surgery showed a significant decrease in serum uric acid levels and decreased xanthine oxidase activity at 6 months…

Even a measure as drastic as weight reduction surgery yields an average of 10% reduction in serum uric acid level. Bottom line, Gout sufferers can’t solve their problem without urate lowering therapy (ULT).

Bariatric surgery is of course useful to address other concomitant conditions like obesity and diabetes.