Question

A 55-year-old man presents with acute onset of a red, hot, swollen first metatarsophalangeal joint. He is in severe pain and cannot bear weight. Serum urate is elevated. According to NICE gout guidance, what is the preferred first-line treatment for this acute flare, assuming no contraindications?

Accepted Answer

Oral non-steroidal anti-inflammatory drug (NSAID) such as Ibuprofen with gastroprotection if needed.

Answer

Long-term Allopurinol initiation during the acute attack.

Answer

Colchicine plus high-dose oral steroids.

Answer

Intra-articular steroid injection only.

Answer

A long-term low-purine diet instead of drug treatment.

Practice question

A 55-year-old man presents with acute onset of a red, hot, swollen first metatarsophalangeal joint. He is in severe pain and cannot bear weight. Serum urate is elevated. According to NICE gout guidance, what is the preferred first-line treatment for this acute flare, assuming no contraindications?