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Acknowledgements The authors acknowledge Dr

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Red flag symptoms requiring urgent medical attention include: Severe, persistent abdominal pain, especially if radiating to the back and accompanied by vomiting (possible pancreatitis) Pain in the upper right abdomen, fever, or yellowing of the skin/eyes (possible gallbladder disease) Blood in vomit or stools Signs of severe dehydration (dark urine, dizziness, confusion) High fever (above 38C) accompanying digestive symptoms Unexplained weight loss beyond expected treatment effects Severe, persistent diarrhoea lasting more than 48 hours If you experience these red flag symptoms, call NHS 111 for advice or 999 in an emergency

1 Irrespective of the specific urate-lowering therapy (ULT) selected, fundamental principles entail commencing treatment concurrently with prophylaxis and initiating with a conservative dosage, followed by systematic monitoring of serum uric acid levels and subsequent dose adjustment until the therapeutic target is attained