Question

A 50-year-old man with painful first MTP swelling and tophus has SUA 9.2 mg/dL and normal eGFR. He has had three flares this year. Which long-term strategy aligns with current gout guidelines?

Accepted Answer

Start allopurinol and titrate to SUA <6 mg/dL

Answer

Start febuxostat and target SUA <8 mg/dL without titration

Answer

Use colchicine PRN for flares only; no urate-lowering therapy

Answer

Start probenecid only if SUA >10 mg/dL

Answer

Start pegloticase immediately in clinic

Practice question

A 50-year-old man with painful first MTP swelling and tophus has SUA 9.2 mg/dL and normal eGFR. He has had three flares this year. Which long-term strategy aligns with current gout guidelines?