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strong-recommendations · fitzgerald-2020-acr-gout-guideline

Revision 56cba031-6e48-466e-b11f-8eb3a84a3be4 · 9/26/2026, 8:24:57 PM UTC
Claim ID
strong-recommendations
Assertion
The ACR guideline's strong recommendations include allopurinol as preferred first-line urate-lowering therapy (including in chronic kidney disease stage 3 or worse), a low starting dose, a treat-to-target strategy with a serum urate goal below 6 mg/dL, anti-inflammatory prophylaxis for at least 3–6 months when starting therapy, and colchicine, NSAIDs or glucocorticoids for flares.
Quote
allopurinol as the preferred first-line ULT, including for those with moderate-to-severe chronic kidney disease (CKD; stage ≥3); using a low starting dose of allopurinol (≤100 mg/day, and lower in CKD) or febuxostat (≤40 mg/day); and a treat-to-target management strategy with ULT dose titration guided by serial serum urate (SU) measurements, with an SU target of [less than] 6 mg/dl. When initiating ULT, concomitant antiinflammatory prophylaxis therapy for a duration of at least 3–6 months was strongly recommended. For management of gout flares, colchicine, nonsteroidal antiinflammatory drugs, or glucocorticoids (oral, intraarticular, or intramuscular) were strongly recommended.
Quote language
en
Locator
section: Abstract: Results
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