In a hot drugs session this morning gout guru Professor Lisa Stamp from the University of Otago in Christchurch, New Zealand, took to the stage to bust the most common myths in gout management.

The 6 myths of gout (and the reality) according to Lisa:

1. You should wait for 2 weeks after an acute attack to start urate lowering therapy.

Reality: You can start ULT whenever is appropriate and convenient 

2. Allopurinol is a weak urate lowering therapy

Reality: The majority of patients achieve target urate if they are adherent and dose is not creatinine clearance (CrCL) based.

3. Benzbromarone is too dangerous to use

Reality: Right patient, right dose, right monitoring

4. Gout attacks stop when target SU is reached

Reality: It takes 12-18 months for attacks to stop

5. Higher doses of allopurinol are associated with adverse events.

Reality: There are multiple risk factors for allopurinol hypersensitivity syndrome (AHS) including starting dose but not maintenance dose.

6. Gout is the “disease of kings”  because it is caused by eating too many decadent foods and drink.

Reality: Genes are more important, and diet education does not lower urate.