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Because gout tends to flare when serum uric acid is lowered, the American College of Rheumatology recommends anti-inflammatory prophylaxis with colchicine or a nonsteroidal anti-inflammatory drug (NSAID) for 3 to 6 months after urate-lowering therapy is begun (NEJM JW Gen Med Jul 1 2020 and Arthritis Rheumatol 2020; 72:879). To examine how often patients have “rebound” flares after stopping prophylaxis, researchers conducted this meta-analysis of 7 studies in which patients with gout received several months of anti-inflammatory prophylaxis while they initiated urate-lowering therapy, and in which the frequency of flares was tracked after prophylaxis was stopped.
Findings were as follows:
During anti-inflammatory prophylaxis, 15% of patients h…