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Acute gout first-line treatment — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsAcute gout first-line treatmentGPhC CRA

A 30-year-old man presents with an acute gout flare in his right knee. He has no other medical conditions, takes no regular medication, and has NKDA. He is in significant pain. What is the most appropriate first-line treatment for his acute flare?

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Correct answer: A — Naproxen 750 mg initially, then 250 mg every eight hours until the attack resolves

For an acute gout flare in a patient with no contraindications, an NSAID at maximum dose is appropriate first-line treatment. Naproxen is commonly used. Colchicine is an alternative but should be used at appropriate doses for acute flare (500 micrograms two to four times daily for a short period, not three months). Allopurinol and febuxostat are urate-lowering therapies and should not be initiated during an acute flare. Prednisolone at 5 mg is too low for acute gout.

Reference: NICE CKS Gout; BNF