The FDA has approved lesinurad (Zurampic – Ironwood), a uric acid transporter 1 (URAT1) inhibitor, for adjunctive treatment of gout-associated hyperuricemia in patients whose serum uric acid levels fail to reach goal with xanthine oxidase inhibitor monotherapy.

STANDARD TREATMENT — Recent guidelines offer conflicting views on the benefits of monitoring serum uric acid levels and the appropriate use of urate-lowering therapy in patients with gout,1-3 but most expert clinicians still initially treat gout-associated hyperuricemia with a xanthine oxidase inhibitor such as allopurinol or febuxostat with the goal of reducing the serum uric acid level below 6.0 mg/dL (and preferably below 5.0 mg/dL). The uricosuric drug probenecid can be used for add-on therapy if target serum uric acid levels are not reached with a xanthine oxidase inhibitor alone or for initial therapy ... more      

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