Question

A 45-year-old man presents with recurrent attacks of acute monoarthritis of the first metatarsophalangeal joint. Serum urate is 0.52 mmol/L (elevated). He has had three attacks in the last year. What is the most appropriate long-term management strategy?

Accepted Answer

Initiate allopurinol and titrate to serum urate <0.36 mmol/L

Answer

Use colchicine only during attacks

Answer

Use NSAIDs only during attacks

Answer

Avoid urate-lowering therapy unless attacks exceed five per year

Answer

Start febuxostat and stop all other medications

Practice question

A 45-year-old man presents with recurrent attacks of acute monoarthritis of the first metatarsophalangeal joint. Serum urate is 0.52 mmol/L (elevated). He has had three attacks in the last year. What is the most appropriate long-term management strategy?