Clinical Insights into Gout Management

This question is drawn from "Clinical Insights into Gout Management: Rheumatology Drugs at a Glance Pt. 4," The Rheumatologist, November 2019.

Which of these statements is false?

A. In a study led by Doherty et al., the 'usual care given by physicians' [defined as gout being managed predominantly by primary care physicians where there may have been insufficient time to educate patients adequately] compared with that provided by dedicated nurse educators showed that nursing-led care was two times better than the physician care group.

B. Less than 40% of gout patients will achieve a target serum urate level of ≤6.0 mg/dL on 300 mg of allopurinol.

C. Allopurinol hypersensitivity syndrome (AHS) is a rare (~1 in 1,000 drug starts), but potentially lethal, complication of gout treatment. We can minimize the risk of this reaction by testing for HLAB*5801 in Koreans with renal disease, Southeast Asians, Han Chinese and African American patients.

D. In 2018, the New England Journal of Medicine published the CARES trial that demonstrated in patients selected for high risk of cardiovascular disease that those receiving febuxostat were at increased risk for sudden cardiac death when compared with patients taking allopurinol.