STATEMENT OF THE CENTRAL ISSUE AND THE CENTRAL MISSION

The international medical community has reached absolute consensus on the pathophysiological principle that gout is curable in principle. This principle has been consistently affirmed in at least 18 international guidelines since 2006: lowering and maintaining serum uric acid below the saturation threshold for a sufficiently long duration will stop new crystal formation and dissolve existing crystals. When the crystal entity no longer exists, the patient is, in essence, cured.

However, the biggest paradox is this: guidelines have been consistent about the principle of “curable in principle,” but they have not formally codified “the goal of curing gout”—defined as a verified crystal-free state at the time of assessment (not a permanent cure), with lifelong maintenance of ULT—as the central treatment destination.

This paradox is the root systemic bottleneck and triggers a serious domino effect:

  • Outcome-standardization organizations (OMERACT, G-CAN) lack an official basis to build cure criteria.

  • Clinical researchers lack a standardized goal framework to design studies that prove achieving – maintaining – verifying a cure state.

  • System architects and policymakers lack direction to design integrated longitudinal outpatient care models and multidisciplinary teams—especially for severe gout with complex chronic multimorbidity.

  • Clinicians and patients lack a shared “destination language,” making long-term care fragmented, adherence poor, and cure outcomes difficult to verify.

  • Specialty medical associations and training/CME programs lack a standardized framework to align recommendations and capabilities.

CENTRAL MISSION OF THE FORUM

3. Tuyên bố vấn đề trung tâm và…

To call on experts involved in building and updating guidelines (EULAR, ACR, and national/regional societies) to formally codify “the goal of curing gout” as the central treatment destination in upcoming guideline updates.

This designation:

  • Belongs to the level of theory and system direction-setting, grounded in a principle that has been consensus for 20 years.

  • Will unblock the foundational translation chain, stimulating outcome standardization, confirmatory research, and feasible practice models.

  • Brings the greatest benefit to patients with severe, complex gout—the group that most needs a cure-oriented goal to reduce complications and improve quality of life.

The Forum creates a space for open and vigorous scientific debate—whether supportive or opposing—to drive this change. The Forum’s objective is to generate a substantive debate; support and critique are both constructive because they bring the issue to the attention of those responsible for guideline development and updates.

Colleagues—especially guideline experts—are invited to participate to help realize the goal that pathophysiological principles have made possible for a long time.

CALL TO ACTION

3. Tuyên bố vấn đề trung tâm và…

Submit your viewpoint, supporting letter, or rebuttal via the form below.

We are prepared to compile and submit a collective letter to guideline task forces if sufficient consensus voices are gathered.