I don’t. The patient should be on prophylactic colchicine (if their renal function allows), and part of their pre-treatment involves the systemic administration of corticosteroids anyway such as hydrocortisone (used in the initial drug trials) or methylprednisolone (Solu-Medrol). It is known t...

I agree with Dr. @Gonzalez. Once the decision is made to treat refractory gout with pegloticase there will be (or should be) a "built-in delay" of 3-5 weeks during which methotrexate or another immunomodulator is typically administered to suppress anti-pegloticase antibody formation and to ensure a ...