When would you recommend uric acid-lowering therapy for a patient with asymptomatic hyperuricemia without comorbidities but with family history of gout?  

I would not recommend treating asymptomatic hyperuricemia unless the patient has clinical gout or concern for proven urate nephropathy (such as with uric acid kidney stones). The family history component is important to acknowledge that the patient may be at greater risk in the future, however, it d...

The answer to this important question is probably evolving. For decades, rheumatologists have practiced and taught the mantra: "Don't treat asymptomatic hyperuricemia", and this recommendation has been recapitulated in recent ACR guidelines related to management of gout (Fitzgerald et al., PMID 3239...