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Gout — SCE Rheumatology MCQ

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ModerateCrystal ArthropathyGoutSCE Rheumatology

A 50-year-old man with gout has a serum urate of 580 micromol/L. He is starting Allopurinol. According to BSR guidelines, what is the recommended starting dose and what should be co-prescribed to prevent flares during urate-lowering therapy initiation?

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Correct answer: C — Allopurinol 100 mg daily with Colchicine 0.5 mg once or twice daily for up to 6 months

BSR 2017 gout guidelines recommend starting Allopurinol at 100 mg daily (50 mg if eGFR <30) and uptitrating monthly in 100 mg increments to achieve target serum urate. Co-prescription of prophylactic Colchicine 0.5 mg once or twice daily (or low-dose NSAID) for up to 6 months is recommended to prevent flares during urate-lowering therapy initiation, as mobilisation of urate crystals during dissolution can trigger acute attacks.

Reference: BSR 2017 - Guidelines for management of gout