Commentaries on the updated American College of Rheumatology guidelines for the management of gout. Urate-lowering drugs (Part 1)

The emergence of updated American College of Rheumatology (ACR) guidelines for the management of gout may serve as a prerequisite for revising the draft Russian Federal Clinical Guidelines (FCGs). Despite some differences, it should be noted that both guidelines are similar in key points concerning the principles of drug correction of hyperuricemia, indications for prescription and algorithms for the use of specific medicaments. The proximity of positions can be also traced in the need for the priority use of xanthine oxidase inhibitors (allopurinol and febuxostat) for urate-lowering therapy (ULT), which is aimed at implementing the target principle of gout management – the strict, constant control of serum levels of uric acid (its value should not exceed 6 mg/dl, or 360 μmol/l). The practical results of ULT in accordance with the basic principles outlined in the FCG have been published earlier.