Question

A 64-year-old woman with recurrent gout flares (3 in the past year) and tophus on exam has eGFR 45 mL/min/1.73 m². Best long-term urate-lowering strategy?

Accepted Answer

Allopurinol, start low and titrate to serum urate <6 mg/dL, with anti-inflammatory prophylaxis

Answer

Probenecid first-line

Answer

Febuxostat first-line for all

Answer

Indefinite colchicine monotherapy

Answer

Intermittent steroid bursts during flares only

Practice question

A 64-year-old woman with recurrent gout flares (3 in the past year) and tophus on exam has eGFR 45 mL/min/1.73 m². Best long-term urate-lowering strategy?