A 27-year-old with new gout and no tophi has two flares in the past 8 months. Serum urate is 8.7 mg/dL; eGFR 75 mL/min/1.73 m². What ULT strategy is r...

Question

A 27-year-old with new gout and no tophi has two flares in the past 8 months. Serum urate is 8.7 mg/dL; eGFR 75 mL/min/1.73 m². What ULT strategy is recommended?

Accepted Answer

Start allopurinol

Answer

Start allopurinol 300 mg daily immediately

Answer

Initiate febuxostat 80 mg daily as preferred first-line

Answer

Probenecid 1 g BID first-line without titration

Answer

Avoid ULT until >=3 flares per year

us-abim MCQ (SBA): Gout-ULT Initiation

A 27-year-old with new gout and no tophi has two flares in the past 8 months. Serum urate is 8.7 mg/dL; eGFR 75 mL/min/1.73 m². What ULT strategy is recommended?