Question

A 52-year-old with recurrent gout flares (3/year) and tophi has eGFR 50 mL/min/1.73 m². Best first-line urate-lowering therapy?

Accepted Answer

Allopurinol, start low (e.g., 100 mg daily) and titrate to urate <6 mg/dL with flare prophylaxis

Answer

Probenecid

Answer

Febuxostat starting at full dose

Answer

Allopurinol PRN during flares only

Answer

Pegloticase infusions

Practice question

A 52-year-old with recurrent gout flares (3/year) and tophi has eGFR 50 mL/min/1.73 m². Best first-line urate-lowering therapy?