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The choice of oral treatment for patients with acute gout flares (i.e., colchicine, nonsteroidal anti-inflammatory drugs [NSAIDs], or steroids) usually is individualized according to potential side effects, drug contraindications, cost, and patient preference. In this U.K. trial, 399 patients with acute gout flares were randomized to naproxen (750 mg initial dose; followed by 250 mg, thrice daily for 1 week) or colchicine (0.5 mg thrice daily for 4 days). Enrolled patients had no major contraindications to either drug; patients with glomerular filtration rate <30 mL/minute were excluded. The first metatarso-phalangeal joint was involved (with or without additional involvement of other lower-limb joints) in 70% of cases.
Both regimens were ef…