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Gout: why is this curable disease so seldom cured?
  1. Michael Doherty1,
  2. Tim L Jansen2,
  3. George Nuki3,
  4. Eliseo Pascual4,
  5. Fernando Perez-Ruiz5,
  6. Leonardo Punzi6,
  7. Alexander K So7,
  8. Thomas Bardin8
  1. 1Department of Rheumatology, City Hospital, Nottingham, UK
  2. 2Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
  3. 3Department of Rheumatology, University of Edinburgh, Centre for Molecular Medicine, Western General Hospital, Edinburgh, Scotland, UK
  4. 4Department of Medicine, Rheumatology Section, Alicante University and General Hospital, University Miguel Hernández, Alicante, Spain
  5. 5Department of Rheumatology, Rheumatology Division, Hospital Universitario Cruces, Vizcaya, Spain
  6. 6Department of Rheumatology, Rheumatology Unit, University of Padova, Padova, Italy
  7. 7Department of Musculoskeletal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
  8. 8Department of Rheumatology, Hopital Lariboisière, Fédération de Rhumatologie, Centre Viggo Petersen, Paris, France
  1. Correspondence to Dr Michael Doherty, Academic Rheumatology, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK; Michael.Doherty{at}


Gout is the most common inflammatory arthritis and one in which pathogenesis and risk factors are best understood. One of the treatment objectives in current guidelines is ‘cure’. However, audits show that only a minority of patients with gout receive adequate advice and treatment. Suboptimal care and outcomes reflect inappropriately negative perceptions of the disease, both in patients and providers. Historically, gout has been portrayed as a benign and even comical condition that is self-inflicted through overeating and alcohol excess. Doctors often focus on managing acute attacks rather than viewing gout as a chronic progressive crystal deposition disease. Urate-lowering treatment is underprescribed and often underdosed. Appropriate education of patients and doctors, catalysed by recent introduction of new urate-lowering treatments after many years with no drug development in the field, may help to overcome these barriers and improve management of this easily diagnosed and curable form of potentially severe arthritis.

  • Gout
  • Arthritis
  • Treatment

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