La gota aguda se presenta como una artritis inflamatoria repentina y muy dolorosa. Un manejo eficaz depende de la acción temprana: la evidencia indica que el tratamiento iniciado lo antes posible tras el inicio del brote conduce a una resolución más rápida de los síntomas.
Recommended first-line options for acute flares are colchicine (within 12 hours of flare onset) at a loading dose of 1 mg followed 1 hour later by 0.5 mg on day 1 and/or an NSAID (plus proton pump inhibitors if appropriate), oral corticosteroid (30-35 mg/day of equivalent prednisolone for 3-5 days) or articular aspiration and injection of corticosteroids.
The task force does not prioritise between these options because of no direct comparative evidence, but unlike 2006 item 4, it recommends considering combination therapy, such as colchicine and an NSAID or colchicine and corticosteroids, which can be proposed for patients with particularly severe acute gout, for instance, when flares involve multiple joints.
Acute flares of gout should be treated as early as possible.
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