With guidelines from the ACR and the European League Against Rheumatism (EULAR) recommending gout patients keep their uric acid levels below 6.0 mg/dL, the Gout & Uric Acid Education Society (GUAES) is emphasizing 6 as a target for patients, says N. Lawrence Edwards, MD, MACP, MACR, chair and CEO of GUAES. Dubbed the Go for Six campaign, the society kicked off the education initiative on May 22, 2015, with Gout Awareness Day.1,2
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Dr. Edwards, who co-authored the ACR’s most current guideline, 2012 Guidelines for the Management of Gout, and is a professor of medicine in and vice chair of the Department of Medicine, University of Florida, Gainesville, Fla., says both organizations support a treat-to-target approach and chose 6.0 mg/dL as the target number because multiple clinical trials demonstrated that when a gout patient suppresses their uric acid level to 6.0 mg/dL or below, their main symptoms may decrease in frequency over the first couple of years of treatment with first-line medications until they completely disappear. And if tophi exist, they may also disappear in time. By comparison, when a patient’s uric acid levels remain above 7.0, their disease continues to worsen over time.
So how do physicians advise patients on how to keep their uric acid levels below 6.0?
Some patients think they can treat gout with diet alone, but Dr. Edwards says that is rarely the case. Although he does recommend a Mediterranean diet, with its emphasis on fresh fruits and fish, Dr. Edwards says, “if [patients] know that certain foods trigger their gout flares, such as red meat, shellfish or beer, then they should avoid them. But doing that alone won’t eliminate gout symptoms.”