Gout is the most common form of inflammatory arthritis worldwide. The cardinal clinical manifestations are gout flares and subcutaneous tophi, which both cause significant pain, disability, reduction in quality of life, and contribute to hospital admissions. A sustained reduction in serum urate of less than 0·36 mmol/L has been shown, with time, to lead to a reduction and cessation of flares and resorption of tophi,1 and this treat-to target urate approach is recommended by rheumatology societies.