Question

A 62-year-old with symptomatic gout, ≥2 flares/year, serum urate 9.2 mg/dL, eGFR 45. Which long-term strategy is preferred?

Accepted Answer

Initiate allopurinol as first-line and titrate to target serum urate <6 mg/dL

Answer

Initiate febuxostat as first-line in CKD and target urate <8 mg/dL

Answer

Avoid urate-lowering therapy; use NSAIDs only

Answer

Probenecid first-line regardless of CKD

Answer

Start allopurinol only if tophi develop

Practice question

A 62-year-old with symptomatic gout, ≥2 flares/year, serum urate 9.2 mg/dL, eGFR 45. Which long-term strategy is preferred?