From: Gout. Novel therapies for treatment of gout and hyperuricemia
Polyarticular gout, uncontrolled flare activity, and/or chronic synovitis |
Destructive tophi |
Advanced age |
Co-morbidities (for example, chronic kidney disease, cardiovascular disease, obesity, metabolic syndrome or diabetes, alcohol abuse) |
Polypharmacy and drug interactions (for example, statins, macrolide antibiotics, oral anticoagulants) |
Contra-indications or refractoriness to NSAIDs, colchicines, and/or glucocorticosteroids |
Allopurinol intolerance or hypersensitivity and inability to employ uricosurics |
Failure to adequately lower serum urate on appropriate doses of urate-lowering drugs |