النقرس في حالة الحساسية أو عدم تحمل الألوبيورينول — الخطوة التالية عندما لا يحقق علاج النوبة الحادة الشفاء

References

DOI: 10.1136/annrheumdis-2016-209707

• Febuxostat or a uricosuric are also indicated if allopurinol cannot be tolerated.
• If the SUA target cannot be reached by an appropriate dose of allopurinol, allopurinol should be switched to febuxostat or a uricosuric, or combined with a uricosuric.
• Prophylaxis is recommended during the first 6 months of ULT.
• Every person with gout should receive advice regarding lifestyle: weight loss if appropriate and avoidance of alcohol (especially beer and spirits) and sugar-sweetened drinks, heavy meals and excessive intake of meat and seafood.
• Low-fat dairy products should be encouraged.
• Regular exercise should be advised.
• For patients on ULT, SUA level should be monitored and maintained to <6 mg/dL (360 mmol/L).
• A lower SUA target (<5 mg/dL; 300 mmol/L) to facilitate faster dissolution of crystals is recommended for patients with severe gout (tophi, chronic arthropathy, frequent attacks) until total crystal dissolution and resolution of gout.
• SUA <6 mg/dL (360 mmol/L) should be maintained lifelong.