What is the first line treatment for acute gout?

The first-line treatment for acute gout is nonsteroidal anti-inflammatory drugs (NSAIDs). This approach is based on their effectiveness in reducing inflammation and relieving pain associated with gout attacks. NSAIDs work quickly to provide symptomatic relief and are generally well-tolerated by patients. Common examples include indomethacin, naproxen, and ibuprofen.

Corticosteroids and colchicine can also be used for treating acute gout, especially in patients who cannot tolerate NSAIDs or when they are contraindicated, but they are not considered the first-line treatment. Allopurinol is primarily used for long-term management of chronic gout and for lowering uric acid levels, but it is not appropriate for acute flare-ups because it can exacerbate inflammation if started during an attack.

By using NSAIDs as the first-line treatment, healthcare providers aim to quickly reduce the acute inflammatory response that characterizes gout, ensuring prompt relief from symptoms.