Fast Five Quiz: Gout Management

Bruce M. Rothschild, MD


August 16, 2022

Long-term management with urate-lowering therapy may improve patient physical function and quality of life. According to ACR guidelines, the preferred urate-lowering agent for most patients is allopurinol, a xanthine oxidase inhibitor, owing to its efficacy, low cost, and safety. Allopurinol is safe for use in patients with kidney disease and heart disease. A study by Yen and college suggests that urate-lowering agents may lower the risk for all-cause mortality in patients with gout. Although the ACR recommends a starting dose of 100 mg daily with gradual upward titration, patients with renal insufficiency should receive a starting dose of 50 mg/dL.

Uricosurics may be a treatment option for patients with underexcretion of uric acid. Probenecid, the only FDA-approved uricosuric agent available in the United States, is recommended alone or in combination with allopurinol for patients with inadequate urate control with allopurinol alone, per Perez-Ruiz and colleagues.

Learn more about gout.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.