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Response to: ’A response to Singh. “Lesinurad combination therapy with allopurinol in gout: do CLEAR studies make the treatment of gout clearer?”' by Valiyil and Schechter
  1. Jasvinder A Singh1,2,3
  1. 1Department of Medicine at the School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2Medicine Service, Birmingham VA Medical Center, Birmingham, Alabama, USA
  3. 3Division of Epidemiology at the School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Dr Jasvinder A Singh, University of Alabama at Birmingham, Birmingham, AL 35294, USA;{at}

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I thank Valiyil and Schechter for their letter1 to the editorial related to clinical studies of lesinurad.2 The letter correctly states that the 200 mg lesinurad dose is the only (initial and maximum) dose that should be prescribed to patients, always in combination with a xanthine oxidase inhibitor. The letter provides an important clarification regarding the dose of lesinurad that was approved by the regulatory agencies. Based on higher toxicity, the sponsor did not pursue regulatory approval (Food and Drug Administration (FDA) and European Medicines Agency (EMEA)) for …

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