🦶 Gout Urate-Lowering Therapy: Indications & Targets
UseUse to determine ULT initiation and target: serum urate ≥ 480 µmol/L starts ULT, ≥ 420 with high-risk feature…
SourceChinese Society of Endocrinology. Guideline for the diagnosis and treatment of hyperuricemia and go…
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Methodology · worked example, guidelines & full notes
ULT is started after an acute flare resolves but is never stopped during a flare in established users, with low-dose colchicine for flare prophylaxis at initiation. (original synthesis · not guideline verbatim)
When to use
Use to determine ULT initiation and target: serum urate ≥ 480 µmol/L starts ULT, ≥ 420 with high-risk features starts ULT, and the target is < 360 (or < 300 with tophi/frequent flares).
How it works
Initiate if urate ≥ 480, or ≥ 420 with flares ≥ 2/yr, tophi, nephrolithiasis, CKD, hypertension, diabetes, dyslipidemia, cardio-cerebrovascular disease, or onset < 40 yr. Target < 360 µmol/L; < 300 with severe disease; not chronically < 180.
Key points
- ULT is started after an acute flare resolves but is never stopped during a flare in established users, with low-dose colchicine for flare prophylaxis at initiation. (original synthesis · not guideline verbatim)
- The target tightens to < 300 µmol/L when tophi, chronic gouty arthritis, or frequent flares are present.
- Before allopurinol in Han Chinese patients, test HLA-B*5801 to reduce severe cutaneous reaction risk.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Serum urate | 500 µmol/L |
|---|---|
| Gout flares ≥ 2/year | Yes |
| Tophi / chronic gouty arthritis / imaging joint damage | Present |
| Any of nephrolithiasis/CKD/hypertension/diabetes/dyslipidemia/cardio-cerebrovascular disease/onset < 40 yr | Present |
→Urate-lowering therapyRecommend starting ULT
- Serum urate：500 µmol/L
- Target urate：< 300 µmol/L (not chronically < 180)
- Initiation threshold：≥ 480 → start; ≥ 420 with frequent flares/tophi/nephrolithiasis/CKD/metabolic or cardio-cerebrovascular disease/onset < 40 yr → start
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Gout Urate-Lowering Therapy: Indications & Targets?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Gout Urate-Lowering Therapy: Indications & Targets upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Gout Urate-Lowering Therapy: Indications & Targets calculated in practice? Can you show a worked example?
- Inputs: Serum urate 500 µmol/L, Gout flares ≥ 2/year Yes, Tophi / chronic gouty arthritis / imaging joint damage Present, Any of nephrolithiasis/CKD/hypertension/diabetes/dyslipidemia/cardio-cerebrovascular disease/onset < 40 yr Present → Result: Urate-lowering therapy Recommend starting ULT（Serum urate: 500 µmol/L, Target urate: < 300 µmol/L (not chronically < 180), Initiation threshold: ≥ 480 → start; ≥ 420 with frequent flares/tophi/nephrolithiasis/CKD/metabolic or cardio-cerebrovascular disease/onset < 40 yr → start）