Question

A 70-year-old on apixaban (for AF) and with CKD stage 3 has an acute gout flare in the first MTP joint. Best initial pharmacologic therapy?

Accepted Answer

Oral prednisone 30-40 mg daily (short taper)

Answer

High-dose NSAIDs

Answer

Colchicine 1.2 mg then 0.6 mg in 1 h, then 0.6 mg BID for 7-14 d without adjustment

Answer

Intra-articular antibiotic injection

Answer

Allopurinol loading dose now

Practice question

A 70-year-old on apixaban (for AF) and with CKD stage 3 has an acute gout flare in the first MTP joint. Best initial pharmacologic therapy?