1. Optimizing Treatment of Refractory Gout

2. Overview of Gout

3. Prevalence of Gout

4. Gout More Than Podagra

5. ACR Gout Classification Criteria

6. Imaging in Gout

7. Identifying Patients With Severe or Refractory Gout

8. Characteristics of Severe Gout

9. Implications of Uncontrolled Gout

10. Treatment Goals in Gout

11. ACR Management Guidelines Use of Pharmacologic ULT

12. ACR/EULAR Treatment Recommendations

13. Allopurinol

14. Febuxostat

15. Pegloticase for Refractory Gout

16. Pegloticase for Refractory Gout Tophi, Uric Acid Reductions

17. Pegloticase for Refractory Gout Safety

18. Limiting Risk for Pegloticase Immunogenicity

19. Investigational Agents for Refractory Gout

20. Limiting AEs in the Management of Gout

21. Concluding Remarks

22. Abbreviations