Which combination therapies may be considered for acute gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

If the patient does not have an adequate response to initial therapy with a single drug, ACR guidelines advises that adding a second appropriate agent is acceptable. Using combination therapy from the start is appropriate for an acute, severe gout attack, particularly if the attack involves multiple large joints or is polyarticular. Acceptable regimens include any of the following, in full or prophylactic doses as appropriate [126] :

  • Colchicine plus NSAIDs
  • Oral corticosteroids plus colchicine
  • Intra-articular steroids plus colchicine or NSAIDs

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