A 58-year-old man has recurrent podagra and serum urate 560 µmol/L. Symptoms settle with naproxen; he now asks about prevention. eGFR is 72

Question

A 58-year-old man has recurrent podagra and serum urate 560 µmol/L. Symptoms settle with naproxen; he now asks about prevention. eGFR is 72 mL/min/1.73 m^2 and he takes amlodipine. What is the most appropriate management?

Accepted Answer

Start low-dose allopurinol with flare prophylaxis and titrate to target urate

Answer

Start allopurinol 600 mg daily without monitoring

Answer

Use colchicine as long-term monotherapy without urate lowering

Answer

Start febuxostat and stop after urate normalises

Answer

Advise purine restriction alone because renal function is normal

Gout urate-lowering therapy — SCE Rheumatology MCQ

A 58-year-old man has recurrent podagra and serum urate 560 µmol/L. Symptoms settle with naproxen; he now asks about prevention. eGFR is 72 mL/min/1.73 m^2 and he takes amlodipine. What is the most appropriate management?