What is the first-line treatment for an initial acute attack of gout?

The first-line treatment for an initial acute attack of gout is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are the most commonly used medications for the management of acute gout attacks due to their effectiveness in rapidly reducing inflammation and alleviating pain. They work by inhibiting the cyclooxygenase (COX) enzymes, which play a key role in the inflammatory process.

In the context of an acute gout attack, prompt relief of symptoms is vital, and NSAIDs like ibuprofen or naproxen are often initiated immediately to help reduce swelling and discomfort. These medications not only address the inflammation but can also help normalize joint function as the acute attack resolves.

While corticosteroids and colchicine can also be effective in treating an acute attack of gout, they are generally reserved for situations where NSAIDs are contraindicated or if the patient has not responded adequately to NSAIDs. Allopurinol, despite being an important medication in the long-term management and prevention of gout attacks, is not appropriate for treating acute attacks as it does not provide immediate relief from acute inflammation.