A 54-year-old with recurrent gout flares (serum urate 8.9 mg/dL) asks when to start urate-lowering therapy. He is in the midst of an acute flare, on N...

Question

A 54-year-old with recurrent gout flares (serum urate 8.9 mg/dL) asks when to start urate-lowering therapy. He is in the midst of an acute flare, on NSAIDs. Best approach?

Accepted Answer

Start allopurinol during the flare and continue anti-inflammatory prophylaxis

Answer

Avoid starting ULT until 2 weeks after flare

Answer

Start allopurinol now but stop NSAID prophylaxis

Answer

Delay ULT until serum urate >10 mg/dL

Answer

Start probenecid now as first-line

us-abfm MCQ (SBA): Gout-Initiating ULT

A 54-year-old with recurrent gout flares (serum urate 8.9 mg/dL) asks when to start urate-lowering therapy. He is in the midst of an acute flare, on NSAIDs. Best approach?