LETTER OF SUPPORT – PROFESSOR NICOLA DALBETH

CENTRAL ISSUE

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Central statement and central mission (the central paradox)

  1. Treatment guidelines have been consistent about the principle of being “curable in principle,” but they have not yet formally adopted “cure” as the central treatment target.

  2. When the goal of cure has not been formally adopted, OMERACT lacks a foundation to develop cure criteria. Without criteria, it is not possible to design confirmatory studies—and it is also not possible to establish cure as a widely applicable real-world clinical practice.

  3. Therefore, what needs to be “unblocked” is the three-layer foundation: principle → goal → criteria.

  4. The central mission of this Forum is to call for consensus among guideline experts to formally incorporate the goal of curing gout into updated guideline versions, and simultaneously to call for consensus to form a working group with OMERACT to research and develop cure criteria.

SYSTEMIC BOTTLENECKS

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Guideline

Acknowledge the principle, but have not yet defined the goal of cure.

OMERACT & Research

Lack the basis to establish cure criteria and to design confirmatory studies.

Clinical practice

There is no clear “destination” for physicians and patients to follow a cure journey.

GLOBAL CONSISTENCY ON THE PRINCIPLE THAT GOUT CAN BE CURED

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Consensus on pathophysiological principle — the scientific foundation for the curability of gout

The Forum recognizes an absolute consistency within the international medical community regarding the biological basis: gout arises and is maintained by the presence of monosodium urate (MSU) crystals. Accordingly, in principle, if serum uric acid is controlled below the saturation threshold long enough to dissolve existing crystals and prevent new crystal formation, the root cause of the disease will be eliminated.
This is the core foundation for establishing the view that “gout can be cured.”

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