Allopurinol-Refractory Gout — RACP Adult Medicine MCQ

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ModerateRheumatologyAllopurinol-Refractory GoutRACP Adult Medicine

A 55-year-old man with recurrent gout on allopurinol 900 mg daily still has urate 0.40 mmol/L (target <0.36). Next option?

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Correct answer: C — Switch to febuxostat

Febuxostat (more potent XOI) is PBS-listed for allopurinol failure/intolerance. Adding uricosurics is an alternative.

Reference: eTG – 2025 – Rheumatology; ACR – 2020; PBS – 2025