Kudos to Dr. O'Dell, et al. They have shown what many of us already have known but needed to get the word out better in a well-done study. Too many other studies and marketing ploys from newer urate-lowering therapies have said (incorrectly) that most allopurinol patients are unable to reach a therapeutic sUA target. However, many of us in clinical practice have known that they simply do not push the drug dose high enough (up to 800 mg daily). In addition, in the "real world," we also educate our patients on urate-lowering diets (low fructose, etc), and include other therapies, such as losartan, and stop urate-increasing meds (eg HCTZ). Most patients can avoid the more expensive therapies. - Thanks, Dr. O'Dell!