Dear Editor, Hyperuricemia is the primary cause of gout attacks. In addition to hyperuricemia, fluctuations in blood uric acid can also trigger acute gout attacks [1]. At present, there is controversy about the timing of urate-lowering therapy (ULT) in gout. Asia-Pacific League of Associations for Rheumatology(APLAR) does not recommend ULT at the onset of acute gout attacks [2], suggesting that these medications should be initiated only after 2weeks of anti-inflammatory treatment. However, both the 2012 and 2020 versions of the American College of Rheumatology (ACR) Gout Management Guidelines recommend cautious initiation during the acute phase: on the basis of adequate anti-inflammatory, ULT can be used during the acute phase of gout [3, 4]. However, this recommendation is based on a limited number of randomized controlled studies, and its strength remains weak [5, 6]. Consequently, it has not gained broad acceptance among domestic and international scholars. Second, there is a lack of clinical research on the effectiveness and safety of early antiinflammatory, analgesic, and ULT combinations for acute gout. Finally, the real-world compliance of gout treatment is not high [7], and most patients do not return to the outpatient clinic for further ULT after a subsidence of an acute attack because no ULT was started in the acute stage. To confirm the efficacy and safety of early combination of anti-inflammation with ULT for acute gout, we retrospectively analyzed the clinical data of six cases of acute gout treated with early anti-inflammatory drugs combined with ULT at our hospital; the results are shown in Table 1.