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Question preview · ABIM Board

A 62-year-old with recurrent gout has 3 attacks in the past year and visible tophi. Serum urate is 8.9 mg/dL and eGFR is 60 mL/min/1.73 m². Which is the best next step?

  1. A. Start colchicine prophylaxis only
  2. B. Advise diet change only
  3. C. Begin febuxostat monotherapy first-line
  4. D. Start allopurinol now and titrate to serum urate <6 mg/dL
  5. E. Start probenecid as first-line therapy

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