Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.

Evidence: FitzGerald JD 2020 · sources last checked 2026-08-20

Reference tool — not medical advice. Thresholds, targets, and first-line agents differ by guideline body and change over time — switch the lens to compare. Clinician judgement, dosing/monitoring, contraindications, and live coverage always required. Runs entirely in your browser — no data is collected.

Gout selector

Choose the guideline lens (ACR / EULAR / BSR), the clinical context (acute flare vs starting urate-lowering therapy), and comorbidities — get the flare agent or ULT plan, the serum-urate target, and the HLA-B*5801 screening prompt. No single Canadian national guideline exists — this synthesizes the three.

Guideline lens

Clinical contextchoose one

Urate-lowering therapy (ULT) indication

Any of these indicates ULT

Comorbidities

Disease severitychoose one

Flags

Clinical context

No current ULT indication — treat flares + lifestyle

Serum-urate target (if on ULT)

< 360 µmol/L (6 mg/dL)

Notes

  • • ACR uses a uniform target < 360 µmol/L with treat-to-target titration. (A Canadian primary-care appraisal, CFP 2020, questions whether aggressive dose-escalation to a numeric target beats standard dosing — a pragmatic caveat.)
  • • Lifestyle/diet (adjunct): limit purine-rich meat/seafood (plant purines lower-risk), high-fructose/sugary drinks and alcohol; favour a Mediterranean/DASH pattern and weight loss; where feasible switch a loop/thiazide diuretic to losartan or a CCB. No single Canadian national gout guideline exists — this synthesizes ACR/EULAR/BSR.

Suggested drug classesPer ACR 2020.

Choose acute flare vs between-flares to begin.

Switch the lens to compare the serum-urate target (ACR <360 uniform vs BSR/EULAR <300 for severe) and ULT-start timing.

Guidelines

References

  1. [1]FitzGerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res 2020;72:744 (treat-to-target; allopurinol-first; HLA-B*5801 screening; start ULT during a flare). link
  2. [2]Richette P, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 2017;76:29. link
  3. [3]Hui M, et al. The British Society for Rheumatology Guideline for the Management of Gout. Rheumatology 2017;56:e1 (stricter urate target). link
  4. [4]Health Canada Safety Review (2019): febuxostat (Uloric) — increased cardiovascular risk; not recommended in ischemic heart disease / heart failure (CARES). Ton J, Kolber MR. Targeting uric acid levels. Can Fam Physician 2020;66:671. link