Treat to Target in Gout Management: A Critical Reappraisal of Current Strategies

• DOI: 10.3390/gucdd3010003
• Publication Date: 2025-02-28T09:28:18Z
• Authors: Anusha Moses; Martijn Oude Voshaar; Mart van de Laar; Tim L. Th. Jansen

Gout management strategies remain a topic of debate, particularly regarding the efficacy treat-to-target (T2T) and treat-to-avoid-symptoms (T2S) approaches. T2T, endorsed by major rheumatology societies, involves systematic serum urate (sUA) monitoring urate-lowering therapy (ULT) dose escalation to maintain sUA below predefined threshold. In contrast, T2S, which focuses on symptom relief rather than routine monitoring, is supported alternative guidelines. Despite widespread adoption T2T in other chronic diseases, its clinical benefits beyond biochemical parameters, such as reduction, uncertain gout. This study evaluates current evidence analyzing data from pragmatic multicenter trial comparing both strategies. Findings suggest that while effective reducing levels, superiority preventing flares improving patient-reported outcomes remains inconclusive. Some studies report reduced tophus burden better adherence with whereas others find negligible differences pain functional improvement between two The lack high-quality comparative trials underscores need for further investigation. Future research should prioritize long-term, patient-centered implementation