Question

A 56-year-old with tophaceous gout and serum urate 9.2 mg/dL (eGFR 55) has ≥2 flares/year. Best long-term urate-lowering approach?

Accepted Answer

Start allopurinol and titrate to serum urate <6 mg/dL with anti-inflammatory flare prophylaxis

Answer

Probenecid monotherapy as first-line

Answer

Febuxostat for all due to kidney disease

Answer

Urate-lowering therapy is contraindicated during quiescent periods

Answer

Diet alone without medications

Practice question

A 56-year-old with tophaceous gout and serum urate 9.2 mg/dL (eGFR 55) has ≥2 flares/year. Best long-term urate-lowering approach?