A 63-year-old man presents with recurrent gout attacks and visible tophi over his elbows. Serum urate is 0.45 mmol/L despite taking allopurinol 100 mg...

Question

A 63-year-old man presents with recurrent gout attacks and visible tophi over his elbows. Serum urate is 0.45 mmol/L despite taking allopurinol 100 mg daily. He has normal renal function. What is the most appropriate target and adjustment of therapy?

Accepted Answer

Increase allopurinol dose gradually to achieve serum urate below 0.36 mmol/L

Answer

Maintain serum urate around 0.45 mmol/L and no change is needed

Answer

Stop allopurinol and switch to NSAIDs alone

Answer

Add a loop diuretic to increase uric acid excretion

Answer

Aim for serum urate above 0.5 mmol/L to prevent flares

au-amc MCQ (SBA): Chronic gout management

A 63-year-old man presents with recurrent gout attacks and visible tophi over his elbows. Serum urate is 0.45 mmol/L despite taking allopurinol 100 mg daily. He has normal renal function. What is the most appropriate target and adjustment of therapy?