1. Treatment algorithm for hyperuricemia in gout
Treatment algorithm for hyperuricemia in gout. (NSAID, nonsteroidal anti-inflammatory drug; SUA, serum uric acid.) aSelf-reported pain score using a visual analog scale of 6 or less is considered mild/moderate pain and 7 or more is considered severe pain. bMay consider switch to alternate monotherapy, add-on combination therapy, or off-label therapy for inadequate response (< 20% improvement in pain score within 24 hours or < 50% at 24 hours or longer). cColchicine recommended only if started within 36 hours of symptom onset. dIntraarticular corticosteroids may be used in combination when only one or two large joints are affected. eCriteria for ULT initiation include: Recurrent attacks (2 or more per year), evidence of tophus or tophi, chronic kidney disease stage 2 or worse, or past urolithiasis. fInitiate concomitant anti-inflammatory prophylaxis and continue for indicated duration. gMay add on uricosuric therapy if unable to achieve target SUA on maximally dosed xanthine oxidase inhibitor therapy; switch to pegloticase for refractory cases.
Source: Gout and Hyperuricemia, Pharmacotherapy Principles & Practice, 4e
Citation: Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, DiPiro JT. Pharmacotherapy Principles & Practice, 4e; 2016 Available at: Accessed: October 19, 2017
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