Starting urate-lowering therapy for the management of gout can be challenging because it may precipitate gout flares. International guidelines recommend colchicine prophylaxis to decrease the frequency, severity, and incidence of multiple gout attack during initiation of urate-lowering therapy. Colchicine prophylaxis is recommended for a duration of 6 months. Studies have shown that patients who took colchicine for 6 months after initiation of urate-lowering therapy experienced significantly fewer gout flares than those who took colchicine for < 6 months. However, colchicine has a narrow therapeutic index with numerous drug interactions. Patients receiving colchicine should be closely monitored and advised regarding the potential for adverse events.
Urate oxidase is used for the management of refractory gout.
Epidemiologic studies have suggested a correlation between high doses of vitamin C and lower serum uric acid levels. However, owing to mixed evidence, current ACR guidelines recommend against adding vitamin C supplementation.
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Cite this: Bruce M. Rothschild. Fast Five Quiz: Gout Management - Medscape - Aug 16, 2022.