Gout Management — SCE Rheumatology MCQ

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ModerateE). Febuxostat or probenecid are options after failure/intolerance (CGout ManagementSCE Rheumatology

A 59-year-old man with polyarticular gout on allopurinol 100 mg daily has urate 464 µmol/L and 2 flares in 6 months. Best next step?

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Correct answer: E — Add probenecid first

Titrate allopurinol to achieve serum urate <357 µmol/L and use anti-inflammatory prophylaxis during titration to prevent flares. Stopping therapy or relying on PRN steroids is inappropriate. Febuxostat or probenecid are options after failure/intolerance.

Reference: ACR Guideline (2020): Gout Management