Brazilian Society of Rheumatology and Brazilian Society of Clinical Pathology/Laboratory Medicine recommendation for serum uric acid test reports on patients undergoing treatment for goutGout is the most common form of inflammatory joint disease in humans [1, 2]. In recent decades, its prevalence has increased due to various factors: dietary habits, increased longevity, the use of hyperuricemic drugs, chronic kidney disease, and metabolic syndrome [1, 2]. Gout is a chronic disease caused by the deposition of monosodium urate (MSU) crystals in various tissues, manifesting as painful and potentially destructive arthritis in the context of hyperuricaemia [2–4]. Population studies in healthy individuals indicate a normal distribution of serum uric acid levels ranging from 3.4 to 7 mg/dL. However, hyperuricemia is defined as a serum urate concentration that exceeds its solubility at normal pH, body temperature, and sodium concentration [5]. The solubility threshold for uric acid is typically 6.8 mg/dL, but in peripheral joints, where body temperature is lower, the threshold is even lower. Therefore, during the treatment of gout, it is recommended that serum urate levels be maintained below 6 mg/dL [2–5]. Adequate control of hyperuricemia is crucial for preventing painful and disabling acute gout attacks. Both the prevention of precipitation and the resorption of already deposited MSU crystals depend on maintaining a serum uric acid level below its solubility threshold. In light of this, the Brazilian Society of Rheumatology and the Brazilian Society of Clinical Pathology/Laboratory Medicine recommend that serum uric acid test reports include a note stating that "In patients undergoing treatment for gout, serum uric acid levels below 6 mg/dL are recommended". This therapeutic target (serum uric acid level < 6 mg/dL), which is well-supported in clinical practice, provides both physicians and patients with a clear and actionable goal, improving the monitoring and management of gout.
Data availability
No datasets were generated or analysed during the current study.
References
- 1 Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol. 2020;16:380–90.
- 2 Mikuls TR. Gout. N Engl J Med. 2022;387:1877–87.
- 3 Richette P, Doherty M, Pascual E, et al. 2016 Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76:29–42.
- 4 Fitzgerald JD, et al. 2020 American College of Rheumatology Guideline for the management of gout. Arthritis Care Res. 2020;72:744–60.
- 5 Sumpter N, Urquiaga M, Takei R, et al. Why 6.8? Gout Urate Cryst Depos Dis. 2024;2:173–205.
