Recent Advances in Gout Management and Cardiovascular Health Outcomes

At the 2025 European Alliance of Associations for Rheumatology (EULAR) congress in Barcelona, significant advancements in the management of gout and its associated cardiovascular implications were presented, highlighting the need for improved treatment protocols. The EULAR guidelines recommend maintaining serum urate levels below 6 mg/dL (360 µmol/L) and ideally under 5 mg/dL (300 µmol/L) for patients with severe gout. Despite the availability of effective treatments, gout remains frequently underdiagnosed and inadequately managed, as noted by Dr. Paul Khanna, a leading rheumatologist and past president of EULAR.

Gout flares have been linked to an increased risk of major adverse cardiovascular events (MACE). New research led by Dr. Edoardo Cipolletta from the University of Milan explored the effects of achieving target serum urate levels on long-term cardiovascular outcomes. Using data from over 116,000 patients in English and Swedish primary care, the study found that those who reached serum urate levels of 360 µmol/L or lower within one year of starting urate-lowering therapy exhibited a significantly lower risk of MACE over five years compared to those who did not achieve these levels (Cipolletta et al., 2025, Annals of the Rheumatic Diseases).

In addition to cardiovascular benefits, the study also noted a decrease in the frequency of gout flares among patients who achieved the recommended serum urate level. This aligns with previous findings that effective urate-lowering treatments can alleviate the burden of gout and its systemic complications. Dr. Cipolletta emphasized that the interaction between age and urate-lowering strategies was notable; older patients over 65 experienced greater benefits from achieving lower urate levels compared to younger patients.

Recent developments in gout therapies also featured prominently at the congress. Pozdeutinurad (AR882), a novel URAT1 inhibitor, demonstrated promising results in reducing serum urate levels and subcutaneous tophi in patients with chronic gout. Dr. Robert Keenan from the University of California presented findings from a Phase 2 open-label trial, indicating that pozdeutinurad was well-tolerated, with mild to moderate treatment-emergent adverse events predominating. Notably, no significant elevations in serum creatinine or clinically relevant liver function abnormalities were observed during the trial (Keenan et al., 2025, Annals of the Rheumatic Diseases).

Another promising treatment, ruzinurad, was compared to allopurinol in a multicenter, randomized, double-blind Phase 3 study. Dr. Huihua Ding reported that a higher percentage of patients receiving ruzinurad achieved the target serum urate level of ≤360 µmol/L compared to those on allopurinol, with the difference remaining significant over the treatment period. The safety profile of ruzinurad was similar to that of allopurinol, with most adverse events classified as mild or moderate (Ding et al., 2025, Annals of the Rheumatic Diseases).

The implications of these findings are profound, suggesting that aggressive management of hyperuricemia can not only mitigate gout symptoms but may also play a crucial role in reducing cardiovascular risk. As the burden of gout continues to grow globally, these insights underscore the importance of education and adherence to treatment protocols among healthcare providers and patients alike.

In conclusion, the EULAR congress has illuminated the critical intersection between gout management and cardiovascular health, paving the way for future research and enhanced clinical practices. Ongoing developments in urate-lowering therapies hold promise for better patient outcomes, but timely diagnosis and effective treatment remain paramount in addressing the complexities of gout and its systemic implications.