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SSc Sexual Dysfunction — SCE Rheumatology MCQ

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HardSystemic SclerosisSSc Sexual DysfunctionSCE Rheumatology

Allopurinol is being titrated monthly in a patient with recurrent gout. Colchicine prophylaxis is tolerated, but serum urate remains above target after three dose increases. How long should prophylaxis continue according to NICE?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Continue colchicine while the target serum urate level is being reached

Explanation lettering: E = shown as A · D = shown as B · A = shown as D · B = shown as E

D is correct. NICE offers colchicine prophylaxis while the serum-urate target is being reached during ULT initiation or titration. A calendar-only two-week stop can leave the patient exposed throughout the mobilisation-flare period, while lifelong colchicine is not routine once stable target control is achieved. If colchicine is contraindicated, not tolerated or ineffective, a low-dose NSAID or oral corticosteroid can be considered; IL-1 inhibition is specialist-reserved after those conventional options fail or cannot be used.

Reference: NICE NG219: gout recommendations: https://www.nice.org.uk/guidance/ng219/chapter/Recommendations