Loading...
Most patients with gout are treated in the primary care setting. Although rheumatology organizations uniformly recommend titrating urate-lowering therapy to achieve serum urate levels <6.0 mg/dL, many patients with gout do not receive urate-lowering therapy at all or are treated with fixed doses (often not exceeding 300 mg daily) rather than titrated doses.
British investigators randomized 517 patients who had experienced gout flares in the previous year to receive care from trained primary care nurses to achieve serum urate targets or to usual care by their general practitioners. Nurses provided intensive education, encouraged patient engagement, and started allopurinol (initial daily dose, 100 mg; titrated upward by 100 mg every 3–4 weeks,…