Gout’s bad rap as disease of dietary excess has sometimes obscured the complex, chronic nature of the disease and led to ineffective care for many patients.

But mounting evidence that gout is a chronic metabolic disease caused by a mix of genetic, environmental, and lifestyle factors is beginning to change that. Experts hope the growing pipeline of drugs targeting the genetics of both the acute and chronic stages of the disease will bring more patients relief. These new tools, along with existing tried-and-true drugs, evidence-based comprehensive care models, and lifestyle advice borrowed from other chronic diseases may help patients and clinicians address gout’s many facets more effectively.