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b'Most patients who suffer an acute gout attack should be started on urate lowering therapy. It is known that starting urate lowering therapy can itself precipitate a gout attack and concern for not worsening the acute symptoms has been the reason some guidelines recommend waiting until after the acute episode has subsided to start urate lowering therapy. A look at recent data indicates waiting for the acute attack to subside may not be necessary Learning Objectives: Understand the principles of urate lowering therapy for preventing gout attacks Be familiar with the risks and benefits or starting urate lowering therapy during an acute gout attack'