The management of gout in the UK is now strictly guided by the NICE NG219 (2022) and the British Society for Rheumatology (BSR) protocols. The cornerstone of modern treatment is the "Treat-to-Target" strategy.

• The Target: The primary goal is to lower serum urate (SUA) levels to <360 µmol/L (or <300 µmol/L for those with tophi or frequent flares).

• The Mechanism: This is achieved through the long-term use of Urate-Lowering Therapy (ULT), primarily Allopurinol.

• Dosage Escalation: Unlike the "set-and-forget" approach of the past, GPs are now encouraged to start Allopurinol at a low dose (100mg) and increase it monthly until the target urate level is reached. In 2026, the NHS has increased funding for primary care monitoring to support this titration-heavy workload.