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Factors beyond urate levels for managing gout flares

Nature Reviews Rheumatology volume 21, pages 371–372 (2025)Cite this article

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Urate crystals alone are required but not sufficient to trigger gout flares; they can also be modulated by environmental, metabolic, genetic and epigenetic factors. Avoiding large variation in urate levels, maintaining prophylaxis until crystal clearance and initiating low-dose urate-lowering therapy are efficient strategies for disease management.

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Acknowledgements

The authors would like to thank their colleagues who contributed to the discussions in this Comment.

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Authors and Affiliations

  1. Université Paris Cité, Inserm U1132, BIOSCAR, AP-HP, Hôpital Lariboisière, Paris, France

    Hang Korng Ea & Pascal Richette

  2. Department of Rheumatology, Centre Viggo Petersen, DMU Locomotion, AP-HP, Hôpital Lariboisière, Paris, France

    Hang Korng Ea & Pascal Richette

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  1. Hang Korng Ea
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  2. Pascal Richette
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Correspondence to Hang Korng Ea.

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Ea, H.K., Richette, P. Factors beyond urate levels for managing gout flares. Nat Rev Rheumatol 21, 371–372 (2025). https://doi.org/10.1038/s41584-025-01255-4

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