Currently recommended treatment for gout attacks

What is the currently recommended treatment for gout attacks?

George Nuki: There really is no very strong evidence favoring one or the other. It can be with low-dose colchicine 1 mg, followed by 0.5 mg an hour or two later, followed then by low-dose colchicine, if necessary, or a nonsteroidal anti-inflammatory drug if there are no contraindications. And the same is true, of course, with colchicine – we have to only use it when there are no contraindications. A short course of corticosteroids systemically can be effective.

For a rheumatologist, often the most effective, quickest way to treat the attack is to aspirate the joint and to inject some steroid. In patients who have multiple polyarticular gout and have contraindications to using steroids, to nonsteroidal anti-inflammatory drugs, to colchicine, you can even use an interleukin-1 inhibitor quite effectively, and although there are no randomized controlled trials to support the use of anakinra, 3 subcutaneous injections of anakinra 100 mg are very, very effective, even in the most severe cases.