XDH and gout: Management guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) emphasize that most gout patients should be treated with a urate-lowering therapy (ULT), ideally a xanthine oxidase inhibitor (XOI), to a serum urate (sU) of ≤ 6.0 mg/dL, or potentially ≤ 5.0 mg/dL in the case of patients with tophaceous gout [12–14].