Gout

Abstract
A 59-year-old man with bilateral olecranon-bursa tophi has frequent bouts of acute gouty arthritis, including three in the past year. Serum uric acid levels are consistently above 9 mg per deciliter. He is moderately obese and has mild, untreated hypertension. Allopurinol was discontinued after a maculopapular rash developed. How should this patient be treated?