Question

A 58-year-old with recurrent gout has had 3 flares this year and tophi on exam. Serum urate 9.0 mg/dL. Best urate-lowering therapy (ULT) plan?

Accepted Answer

Allopurinol with anti-inflammatory prophylaxis for 3-6 months

Answer

Probenecid first line; no prophylaxis

Answer

Allopurinol start at 300 mg daily immediately

Answer

Allopurinol is contraindicated in tophaceous gout

Answer

No ULT; treat flares only

Practice question

A 58-year-old with recurrent gout has had 3 flares this year and tophi on exam. Serum urate 9.0 mg/dL. Best urate-lowering therapy (ULT) plan?