Table Info

Table 3.

Overview of urate-lowering therapy for gout

Drug	Dosing regimen for urate-lowering therapy
Drug	Normal renal function	Advanced CKD (eGFR ≤ 30 mL/min/1.73 m²)	Dialysis	Renal transplant
Allopurinol	Starting dose 100 mg daily. titrate to target (maximum dose 800 mg daily)	Starting dose 50–100 mg daily or every other day. Titrate to target	50–100 mg after dialysis. Titrate to target	Starting dose 50–100 mg daily. Titrate to target
Febuxostat	Starting dose 40–80 mg daily. Titrate to target (maximum dose 120 mg daily)*	Starting dose 20–80 mg daily. Titrate to target	Starting dose 20–80 mg daily. Titrate to target	Starting dose 40–80 mg daily. Titrate to target
Pegloticase	8 mg IV every 2 weeks	8 mg IV every 2 weeks	8 mg IV every 2 weeks	8 mg IV every 2 weeks

CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; IV: intravenous. * Food and Drug Administration approved the maximum dose of febuxostat at 80 mg daily

Declarations

Disclaimer

The opinions expressed in this article are those of the authors and do not necessarily represent those of the Department of Veterans Affairs or the United States Government.

Acknowledgments

The authors wish to thank Heidi Patterson, Veterans Affairs Pittsburgh Healthcare System Librarian, for the literature search.

Author contributions

JSR: Conceptualization, Writing—original draft, Writing—review & editing. NN and MR: Writing—original draft, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interest

The author declares that there are no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

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Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

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Copyright

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