Question

A 52-year-old with gout and CKD stage 3 has recurrent flares and tophi. Serum urate is 9.2 mg/dL. Best long-term urate-lowering therapy strategy?

Accepted Answer

Start allopurinol at low dose (<=100 mg/day; <=50 mg/day in advanced CKD) and titrate to urate <6 mg/dL

Answer

Start high-dose allopurinol 300 mg/day immediately

Answer

Use febuxostat only in all patients

Answer

Avoid urate-lowering therapy until flares cease

Answer

Colchicine alone long-term without urate lowering

Practice question

A 52-year-old with gout and CKD stage 3 has recurrent flares and tophi. Serum urate is 9.2 mg/dL. Best long-term urate-lowering therapy strategy?