Question

A 35-year-old with long-standing gout and ≥2 flares/year has serum urate 9.0 mg/dL and normal eGFR. What is the recommended urate-lowering strategy?

Accepted Answer

Start allopurinol 100 mg daily and titrate to target serum urate <6 mg/dL; give flare prophylaxis

Answer

Start allopurinol 300 mg daily immediately

Answer

Start febuxostat only if HLA-B*58:01 positive

Answer

Use probenecid as first-line in all patients

Answer

Avoid urate-lowering therapy because asymptomatic today

Practice question

A 35-year-old with long-standing gout and ≥2 flares/year has serum urate 9.0 mg/dL and normal eGFR. What is the recommended urate-lowering strategy?