The Singapore Family Physician

Back to issue Vol 49 No. 1 - Chronic Disease Management 2023

Initiation of Urate Lowering Therapy (ULT)

Richard Lee Meng Kam
Anita Lim Yee Nah
The Singapore Family Physician Vol 49 No 1 - Chronic Disease Management 2023
23 - 27
1 January 2023
0377-5305
Mr Tan, 60, a smoker with diabetes mellitus (DM), hypertension and chronic kidney disease (CKD) Stage 3, and recurrent gout flares last five weeks of increasing intensity and duration. He assumes it is due to frequent travel and lack of exercise. He comes today for routine review of his chronic diseases. Current laboratory results are creatinine 106, eGFR 56, uric acid 490, HbA1c 7.3%, random hypocount 8.5 mmol/L. He is on glipizide 5mg bd, Metformin 250mg BD, Amlodipine 5mg OM. He complains of severe gout pain. He had always been reluctant to start definitive treatment which you had previously mentioned. What will you do next?