Treatment failure gout.

Treatment options for gout are well established and reasonably effective.1 They include anti-inflammatory agents such as non-steroidal anti-inflammatory drugs (NSAIDS), glucocorticoids and colchicine and urate-lowering therapies such as allopurinol and probenecid. However, despite the availability of effec-tive urate-lowering therapy, there remains a subset of patients with gout who, de-spite aggressive therapy, have intractable disease, manifest as recurrent gout flares, chronic arthritis and progressive topha-ceous deposits. These patients are referred to as having “refractory gout ” or “treat-