High-strength evidence supports the use of colchicine, nonsteroidal an anti-inflammatory drugs (NSAIDs), and systemic corticosteroids to reduce pain in patients with acute gout. Moderate-strength evidence supports the use of animal-derived ACTH formulation for this condition. Moderate-strength evidence supports the finding that low-dose colchicine is as effective as higher-dose colchicine for treating acute gout descent and has fewer side effects. Evidence is insufficient from randomized controlled trials that assess symptomatic out comes for specific dietary therapies. The evidence is also insufficient to support or refute the effectiveness of particular Traditional Chinese Medicine practices (e.g. Herbal mixtures, acupuncture, and moxibustion) for symptomatic outcomes. High-strength evidence supports that urate-lower therapy (ULT, with allopurinol or febuxostat) reduces serum urate levels.
              However low-strength evidence supports the finding that treating to a specific target serum urate level reduces the risk of gout attacks. High-strength evidence supports the finding that ULT does not reduce the risk of acute gout attacks within the first 6 month of after directness. However, moderate-strength evidence supports the turn of ULT in reducing the risk of acute gout attacks after about 1 year of treatment. Low-strength evidence supports treating a specific target serum urate level to reduce the risk of gout attacks. High-strength evidence supports the finding that prophylactic therapy with low-dose colchicine or depressed dose NSAIDs reduces the risk of acute gout attacks when beginning ULT. No criteria for when to discontinue ULT have been validated.