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Gout (Long-term) — UKMLA MCQ

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HardRheumatologyGout (Long-term)UKMLAMRCGP AKTPARAMRCP Part 1

A patient begins urate-lowering therapy after frequent gout flares. Which additional treatment should be discussed to reduce mobilisation flares during titration?

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Correct answer: C — Use low-dose colchicine prophylaxis

The best answer is “Use low-dose colchicine prophylaxis”. Starting and titrating urate-lowering therapy can transiently increase flares. NICE recommends discussing prophylaxis, commonly colchicine, while the urate target is being reached, with alternatives chosen when contraindications or interactions exist. Prophylaxis does not replace treat-to-target titration and should not involve long-term systemic corticosteroids or antibiotics.

Reference: NICE NG219: Gout diagnosis and management: https://www.nice.org.uk/guidance/ng219/chapter/Recommendations