More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives.

Gout is the most common inflammatory arthritis, but its burden is not shared equally across populations. Recent research has revealed substantial racial and ethnic disparities in both who develops gout and the care patients receive. These differences reflect not only genetic susceptibility but also the substantial influence of social determinants of health, healthcare access, and environmental exposures.

The striking propensity for gout flares to initiate at night has been recognised for centuries. In 1683, Thomas Sydenham famously observed that the typical patient "goes to bed and sleeps in good health" only to be awakened around 2:00 AM by excruciating pain.