A 45-year-old man with a history of recurrent gouty arthritis comes to the physician for a follow-up examination. Two months ago, he had an episode of big toe swelling and pain . Since then, he has had another acute gout attack, which resolved after treatment with ibuprofen. His temperature is 37.1°C (98.8°F). Physical examination shows painless, chalky nodules on the metatarsophalangeal joint of his right foot. Past medical history is notable for hypercholesterolemia, for which he takes atorvastatin. He also has a history of recurrent renal colic. Serum uric acid level is 9.8 mg/dL. Which of the following is the best agent for long-term management of this patient?

Question

A 45-year-old man with a history of recurrent gouty arthritis comes to the physician for a follow-up examination. Two months ago, he had an episode of big toe swelling and pain . Since then, he has had another acute gout attack, which resolved after treatment with ibuprofen. His temperature is 37.1°C (98.8°F). Physical examination shows painless, chalky nodules on the metatarsophalangeal joint of his right foot. Past medical history is notable for hypercholesterolemia, for which he takes atorvastatin.  He also has a history of recurrent renal colic.   Serum uric acid level is 9.8 mg/dL.  Which of the following is the best agent for long-term management of this patient?

Quizplus · Accepted Answer

Eductional Objective: Chronic uric acid-lowering therapy is recommended for patients with gout who have frequent gouty attacks, uric acid kidney stones, tophi, or chronic joint destruction from gout.  Xanthine oxidase inhibitors are the preferred treatment.

A 45-Year-Old Man with a History of Recurrent Gouty Arthritis