ACR/EULAR Gout Classification Criteria 2015
ACR/EULAR 2015 classification criteria for gout. Score ≥8 classifies as gout.
Score interpretation
Score < 8 — the 2015 ACR/EULAR gout classification criteria are not met
→ Consider alternative crystal arthropathy (CPPD, hydroxyapatite), septic arthritis, psoriatic arthritis; aspirate joint if possible; if clinically suspicious, repeat urate level during attack; rheumatology referral
Score ≥ 8 — gout classified (2015 ACR/EULAR)
→ Adults: acute attack — colchicine 0.5 mg BD or NSAIDs (indometacin 50 mg TDS) or prednisolone 30–35 mg/day; avoid aspirin (raises urate). Urate-lowering therapy (ULT): start allopurinol after acute attack resolves; target urate <0.36 mmol/L (0.30 mmol/L if tophi); titrate allopurinol from 100 mg (50 mg in renal impairment); cover ULT initiation with colchicine prophylaxis 3–6 months; lifestyle: reduce alcohol, high-fructose foods, red meat. Children: use a children's formulary.
MSU crystals in a symptomatic joint, bursa or tophus classify gout without scoring (2015 ACR/EULAR step 2)
→ Adults: acute attack — colchicine 0.5 mg BD or NSAIDs (indometacin 50 mg TDS) or prednisolone 30–35 mg/day; avoid aspirin (raises urate). Urate-lowering therapy (ULT): start allopurinol after acute attack resolves; target urate <0.36 mmol/L (0.30 mmol/L if tophi); titrate allopurinol from 100 mg (50 mg in renal impairment); cover ULT initiation with colchicine prophylaxis 3–6 months; lifestyle: reduce alcohol, high-fructose foods, red meat. Children: use a children's formulary.
Interpretation bands for the Gout Criteria. Apply clinical judgement and local guidance.
References
- Neogi T, et al. 2015 Gout Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheumatol. 2015;67(10):2557-2568.
Related
Curated clinical cross-links plus same-class fallbacks.
- Allopurinol · Xanthine Oxidase Inhibitor — Uric Acid Stone Prevention
- Noradrenaline (Norepinephrine) · Vasopressor (Alpha-1 and Beta-1 Agonist)
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Acipimox · Lipid-modifying agent (Nicotinic acid derivative)
- Colesevelam hydrochloride · Bile acid sequestrant
- Icosapent ethyl · Eicosapentaenoic acid (purified omega-3)
- Cutaneous Lupus Erythematosus · BAD; EULAR
- Osteoporosis / Fragility Fracture · NOGG 2021; NICE NG147; NG224
- Arteritic AION (Giant Cell Arteritis) · RCOphth; BSR
- Osteoarthritis Hip / Knee Management · NICE NG226 (2022)
- Lupus Nephritis · EULAR/ERA-EDTA 2019; KDIGO 2024
- Rheumatoid Arthritis Management · NICE CG79 2018 / EULAR 2022
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.