By switaschek, 7 July, 2020 Don’t use pegloticase as 1st-line ULT, reserve for select resistant cases1,2
By switaschek, 7 July, 2020 Consider HLA-B*5801 allele testing before starting allopurinol in African American and certain Asian pts1
By switaschek, 7 July, 2020 Start anti-inflammatory ppx (colchicine, NSAID, steroid) w/ ULT, continue 3-6mo1-3
By switaschek, 7 July, 2020 If mod/severe CKD (stage ≥3): allopurinol, febuxostat preferred over probenecid; start lower dose, depending on CKD stage (allopurinol ≤100 mg/day, febuxostat ≤40 mg/day)1
By switaschek, 7 July, 2020 Allopurinol strongly preferred 1st-line agent in all pts; start 100 mg/day1,2
By switaschek, 7 July, 2020 Start low-dose xanthine oxidase inhibitors (XOI) as 1st-line ULT, titrate to serum urate