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Where possible, missing standard deviations will be calculated from other statistics such as standard errors, CIs or P values, according to methods recommended in the Cochrane Handbook for Systematic Reviews of Interventions ().

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The ACR gout guidelines suggest that urate-lowering therapy could be started during an acute gout attack, providing that effective acute management is instituted, and these recommendations are based on "consensus opinion of experts, case studies, or standard of care", rather than RCT evidence, as we have shown ().

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The anti-inflammatory and anti-hyperuricemic effects of Chinese herbal formula danggui-nian-tong-tang on acute gouty arthritis: a comparative study with indomethacin and allopurinol.

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The ACR preliminary criteria for the classification of acute arthritis of primary gout remain the most frequently used criteria for chronic gout diagnosis in clinical trials ().

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Urate-lowering therapy reduces serum urate concentrations to subsaturating levels preventing the formation and deposition of urate crystals and consequently reduces the long-term manifestations of chronic gout.

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An analysis of current usage suggests that the incidence of acute gouty attacks has diminished to less than 1%.

To assess the efficacy and safety of allopurinol compared with placebo and other urate-lowering therapies for treating chronic gout.

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To enable comparison and pooling of the results of RCTs, we suggest that future trials report means with SDs for continuous measures and number of events and total numbers analysed for dichotomous measures, and assess outcomes recommended by OMERACT (Outcome Measures in Rheumatology) for studies of acute gout, including pain, joint swelling, joint tenderness, participant global assessment and activity limitations ().

For dichotomous data, we presented the results as risk ratios (RR) with corresponding 95% confidence intervals (CI).

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