How would you manage gout with hyperuricemia >10 mg/dl despite the maximum dose of allopurinol plus probenecid and a prior allergic reaction to pegloticase?

Topics: Rheumatology • Crystal Arthritis

Answer from: at Academic Institution

I am not sure what dose of allopurinol the patient is taking, how long he was on pegloticase, and if he had MTX or MMF with it. I can usually reduce the uric acid level with allopurinol and febuxostat. The key question here is whether the patient is taking the drug daily or not.

Comments

at Sidney Kimmel School of Medicine
I agree. Check for compliance. I have also seen SG...

at Florida Medical Center
If a patient had prior treatment with pegloticase ...

at University of Utah
How long can we use the pegloticase for, as there ...

Answer from: at Academic Institution

I'm curious what the 'maximum' dose of allopurinol is. I've used as high as 800 mg a day. I also presume that the patient may not be compliant/taking the correct dose if their uric acid is not changing at all.

Comments

at Kaiser Permanente
The dose is 800 mg of allopurinol per day. Yes, pe...

at Medical City Healthcare
Then I would use high-dose Uloric, such as 100 mg ...

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