What is the preferred medication for the acute treatment of gout?

Colchicine is preferred for the acute treatment of gout because it effectively reduces inflammation and alleviates pain associated with gout flares. Its mechanism involves disrupting the inflammatory response, which is primarily driven by crystals of monosodium urate in the joints. By inhibiting the migration of neutrophils, colchicine decreases the inflammatory response and helps to mitigate the severe discomfort of an acute gout attack.

While medications like allopurinol are important for long-term uric acid control, they are not ideal for treating acute flares due to their mechanism, which takes time to affect uric acid levels. Probenecid, which increases the renal excretion of uric acid, is also not utilized for acute attacks but rather for chronic management. Corticosteroids can be used in certain cases, particularly when inflammation is extensive or if there are contraindications to other medications, but colchicine is commonly chosen due to its specific action during gout episodes. Thus, colchicine remains a cornerstone in the rapid management of acute gouty arthritis.