RG - Amen! Great insights from a great rheumatologist! While its great to have new therapies to manage difficult gout - since when is difficult gout defnined as someone who doesnt respond to subtherapeutic doses of allopurionol. The great marketing flaw is to sell the new drug based on this and the big bad problem of allopurinol hypersensitivity ! I may be the luckiest outlier rheumatologist in the country but Ive yet to have a case of DRESS or other severe allopurinol reactions. Rheumatologists are incredibly smart and keen to these issues in gout care. My article was meant to rile up the rheums to take a greater role in educating and caring for gout. This is best done by promoting, advertising and boasting about how you want to care for all gout patients in your system or community. Thanks! JC