At the American Rheumatology Annual Meeting, which ended on November 13, the 2020 Gout Clinical Practice Guideline (draft) was released, with a number of recommendations that made a big difference, such as: recommending uric acid-lowering therapy during the acute phase and opposing alkalinization of urine, etc. Here are 8 more subversive points of the update. 1.Start uric acid-lowering therapy in the acute phase As long as there are indications for uric acid-lowering therapy, it is conditionally recommended that uric acid-lowering therapy should be started during the attack, rather than waiting for the acute attack to remit. 2.It is recommended to use uric acid-lowering therapy drugs indefinitely as opposed to stopping them. In the past, both patients and doctors were skeptical about the need for long-term uric acid-lowering therapy, and this edition of the guideline finally makes it clear that the course of treatment is no course of treatment. 3, against checking urine uric acid levels and alkalinizing urine therapy 4, colchicine do not use according to the instructions If you choose to use colchicine, the usage recommended by the Chinese drug instructions is not recommended. It is highly recommended to choose low-dose colchicine (such as 0.5 mg, tid) instead of high-dose colchicine, which has a consistent therapeutic effect with greatly reduced adverse effects. 5. First-line drug recommendation for uric acid-lowering therapy For those with chronic kidney disease CKD stage 3 or above, the choice of xanthine oxidase inhibitor (XOI)-allopurinol or febuxostat is strongly recommended over pro-uric acid excretory drugs (propofol). 6. Restrict high fructose corn syrup intake Restriction of alcohol and high purine diet is more accepted, and restriction of high fructose corn syrup intake should receive greater attention. 7. Oppose vitamin C supplements Regardless of disease activity, oppose the application of vitamin C supplements. 8. HLA-B*5801 gene testing is recommended for Asian populations prior to allopurinol use to exclude carriers (approximately 7.4%) to reduce the incidence of serious adverse drug reactions.