Which prophylactic therapies best prevent gout attacks?

Abstract

Q. Which prophylactic therapies best prevent gout attacks? A. Allopurinol and febuxostat reduce the frequency of gout attacks equally after 8 weeks of treatment (strength of recommendation [SOR]: B, multiple randomized control trials [RCTs] with limitations). Intravenous pegloticase decreases serum uric acid and gout attacks and improves quality of life (QOL) (SOR: A, 2 RCTs). Colchicine reduces gout attacks when combined with probenecid or allopurinol at the start of urate-lowering therapy (SOR: B, 1 high-quality and 1 low-quality RCT).