How would you manage a patient with non-tophaceous gout with renal insufficiency who previously failed allopurinol and now has a serum urate > 7 despite while on febuxostat 80 mg daily?

Provided the patient is compliant with the current Uloric dose of 80 mg daily and has ongoing flares (symptomatic), options are:

1. Trial increasing the dose of Uloric to 120 mg daily, which is off-label in the US (approved in European and other countries, even in patients with moderate CKD; less defi...