Gout was the subject of nearly 30 abstracts and the first plenary session in more than 20 years at the recent American College of Rheumatology (ACR) 2004 annual meeting held in San Antonio, Texas. The prevalence of gout, the most common form of arthritis in men older than 40, is increasing worldwide. Interest was strong also for a session on a new treatment for rheumatoid arthritis patients who respond inadequately to anti-TNF therapy.