most patients with gout are underexcretors

[aspiringmd1015]

so shouldnt patients be put on probenicid instead of XO inhibitors for prophylactic treatment?

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[Coldplayfan123]

so shouldnt patients be put on probenicid instead of XO inhibitors for prophylactic treatment?

You still have a lot of uric acid in your body. Overproduction and under excretion lead to the same effect of high urate in the blood. Xanthine oxidase will help under excretion.

 

[aspiringmd1015]

once uric acid is made its not going to get converted to Xanthine.

 

[AZ7]

once uric acid is made its not going to get converted to Xanthine.

XO inhibitors are anyways not used in acute attacks. Used for long term treatment. The reduced net production of uric acid will therefore be able to be cleared adequately by the already under excreting patient, as the threshold is probably not reached.