A recommendation development group consisting of 78 rheumatologists from 14 countries in Europe, South America and Oceania formulated 10 questions on the diagnosis and management of gout according to the “3e” protocol (evidence, expertise, communication) and based on the most important current clinical issues. The final recommendations were made. The study was published in the Annals of Rheumatic Diseases. Recommendations for the diagnosis and management of gout: To establish a diagnosis of gout, sodium urate crystals should be identified; when this is not possible, the diagnosis of gout may be supported by the presence of typical clinical manifestations (e.g., foot gout, gout stones, rapid response to colchicine therapy) and/or characteristic imaging findings in patients. For patients with gout and/or hyperuricemia, testing of renal function and assessment of cardiovascular risk factors are recommended. Treat acute gout with low-dose colchicine (maximum dose of 2 mg/d), non-steroidal anti-inflammatory drugs (NSAIDs) and/or glucocorticoids (intra-articular, oral or intramuscular), depending on comorbidities and risk of adverse effects Patients are advised to adopt a healthy lifestyle, including weight loss, regular exercise, smoking cessation, and avoidance of heavy alcohol and sugary drinks. Allopurinol should be the first-line uric acid-lowering therapy; when allopurinol is not available, alternative options are uric acid excretory drugs (e.g., benzbromarone, probenecid) or febuxostat; uricase monotherapy may be considered only if the patient has severe gout and other medications have failed or are contraindicated. Uric acid-lowering therapy (except uricase) should be started at low doses and gradually increased to achieve serum uric acid targets. Patient education regarding the risk and management of gout flares must be provided during treatment with uric acid-lowering medications; colchicine (maximum dose of 1.2 mg/d) may be considered for flare prevention, and NSAID or low-dose glucocorticoids may be considered if use is contraindicated or not tolerated. The duration of prophylactic treatment depends on the individual patient’s condition. For patients with mild to moderate renal impairment, allopurinol may be administered under close monitoring, starting at a low dose (50-100 mg) and gradually increasing to achieve the target serum uric acid; febuxostat and benzbromarone may be used as alternative therapeutic agents without dose adjustment. The targets for treatment are serum uric acid below 0.36 mmol/lL (6 mg/L), absence of gout attacks and gout stone lysis; monitor serum uric acid levels, number of gout attacks and gout stone size. Gout stones should be treated by continuous reduction of serum uric acid levels [preferably below 0.30 mmol/L (5 mg/L)]; surgical treatment should be performed only in selected cases (e.g., nerve compression, infection, etc.). In asymptomatic hyperuricemia, pharmacological treatment to prevent gouty arthritis, nephropathy or cardiovascular events is not recommended.