Gout: diagnosis and management—summary of NICE guidance

### What you need to know Gout is a painful and debilitating condition with long term complications, including joint damage and renal stones. Although gout flares are often treated with NSAIDs, colchicine or steroids, those with gout often continue to have flares which could have been prevented with lifestyle modification or urate lowering medication. However, only a third of people with gout receive urate lowering therapies (ULTs), and only a third of those have their serum urate level managed effectively.1 This article summarises the recommendations from the new National Institute for Health and Care Excellence (NICE) guideline, focusing on the diagnosis and management of gout.2 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Committee’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Diagnosis and assessment Most people with gout receive a clinical diagnosis in primary care, which is then confirmed by clinical investigation. #### Signs and symptoms