Question

A 52-year-old man with primary gout (tophi absent) has serum urate 9.0 mg/dL and >=2 attacks/year; eGFR 55 mL/min/1.73 m². Best long-term urate-lowering therapy?

Accepted Answer

Start febuxostat as first line

Answer

Start allopurinol at low dose and titrate to target <6 mg/dL

Answer

Start probenecid as first line

Answer

Pegloticase infusion first line

Answer

Diet alone without pharmacotherapy

Practice question

A 52-year-old man with primary gout (tophi absent) has serum urate 9.0 mg/dL and >=2 attacks/year; eGFR 55 mL/min/1.73 m². Best long-term urate-lowering therapy?