La goutte aiguë se manifeste sous forme d'une arthrite inflammatoire soudaine et extrêmement douloureuse. Une prise en charge efficace repose sur une intervention précoce — les données probantes indiquent que le traitement initié le plus tôt possible après le début de la crise conduit à une résolution plus rapide des symptômes.
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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