Principles of pharmacological management for acute gout

The aim of management for an acute gout attack is to provide rapid symptom relief. In early disease, an acute attack of gout can subside spontaneously within a week, but patients usually seek medical advice. Corticosteroids (local injection or systemic use), nonsteroidal anti-inflammatory drugs (NSAIDs), and low-dose colchicine are all effective in treating acute gout. Drug choice is influenced by patient factors (including comorbidities), potential drug interactions and adverse effects, and drug cost. For drug regimens, see Drug regimens for acute gout.

Implement the other aspects of gout management (see Management overview for gout), including a discussion of the disease (see Information for patients diagnosed with gout) and lifelong urate-lowering therapy. It is safe to start or modify urate-lowering therapy during treatment of an acute attack. If patients are already taking urate-lowering therapy, consider if the treat-to-target uric acid level is being met.