Gout may be one of the oldest known forms of arthritis, but it remains widely misunderstood, undertreated, and a source of silent suffering for millions of people who are often blamed for their disease rather than offered effective care. Current therapies to lower urate levels suffer from limitations and safety challenges. Crystalys Therapeutics is in late-stage development of a next‑generation urate inhibitor that is already approved in Japan and China. Crystalys CEO James Mackay discusses the biology of gout, why standard therapies often fail to get uric acid to target levels, and how the company’s next‑generation URAT1 inhibitor may fill the treatment gap and change daily life for patients living with moderate to severe gout.