Therapy to prevent progression of gout may include medications and lifestyle changes that can be used long-term to lower urate levels and thus prevent or reverse the urate crystal deposits that cause worsening of gout. Progressive gout can cause severe gouty arthropathy, disability, kidney stone formation, and possibly kidney damage. People who have one or more of these complications are especially strongly encouraged to take a urate-lowering treatment.
Not everyone with gout will require urate-lowering therapy; those very fortunate few who have rare or mild attacks may be able to manage their gout by treating the acute attacks alone, but if progression to joint damage or tophus development occurs, even these individuals should receive urate-lowering medication. On the other hand, people with frequent gout flares or with flares that are unusually prolonged, painful, or disabling, or with gouty joint damage or tophi should always be encouraged to take urate-lowering therapy.