Treatment Plan & Prognosis

Treatment Plan

Acute flare:

• Self-limiting: resolves 5-15 days
• NSAIDs (naproxen, ibuprofen) + PPI cover
• Colchicine
• Oral corticosteroids
• Rest, elevation, ice packs

Follow-up:

• Review at 4-6 weeks
• Monthly blood tests until normalised (<360)
• Consider ULT initiation

Urate-lowering therapy (ULT):

• Indications: multiple flares, CKD stage 3-5, tophi, gouty arthritis
• First line: allopurinol, febuxostat
• Target uric acid <360 micromol/L
• If chronic changes/tophi: target <300 micromol/L
• Monthly monitoring until the target is reached, then annual
• Continue during acute flares

Prognosis

Complications:

• Cardiovascular disease
• Chronic arthritis
• CKD
• Joint damage
• Renal stones
• Tophi formation