2) A 57-year-old man presents for evaluation of severe right ankle pain and swelling that started last night and has progressively worsened. He was diagnosed with gout 1 year ago when he presented with right-sided first metatarsophalangeal joint pain and swelling. He was subsequently started on allopurinol; since then, the dose has been titrated up to 300 mg daily. The uric acid level 2 weeks ago was 7.9 mg/dL. His other medical conditions include obesity, coronary artery disease, and hypertension. He takes losartan, hydrochlorothiazide, atorvastatin, and low-dose aspirin. On physical examination today, his right ankle is warm to the touch and is swollen with mild erythema. He is treated with prednisone taper over the next 10 days, which results in complete resolution of the symptoms. His allopurinol dose is increased to 400 mg daily. What is the next step in reducing hyperuricemia in this patient?
