Gout Treatments: Medication and Natural Guide
Gout affects approximately 2% of the French population according to Health Insurance, causing intense joint pain that can significantly impact quality of life. This metabolic disease, characterized by excess uric acid in blood, requires adapted therapeutic management combining medications and natural approaches.
According to a 2024 NIH study, combining conventional treatments and lifestyle modifications significantly improves gout patient prognosis. This complete guide presents all available therapeutic options, their mechanisms of action and clinical efficacy.
Medications for Acute Attack
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are first-line therapy during acute gout attack. Indomethacin, prescribed at 50mg three times daily, remains the reference with 85% relief rate at 48 hours by clinical data.
Other effective NSAIDs include:
- Diclofenac: 50mg three times daily
- Naproxen: 750mg loading, then 250mg every 8 hours
- Ibuprofen: 800mg three times daily
Important: NSAIDs are contraindicated with severe kidney failure, active peptic ulcer or pregnancy.
Colchicine
Colchicine represents effective NSAID alternative. HAS recommendations advocate 1mg at first symptoms, followed by 0.5mg one hour later, then 0.5mg 2-3 times daily.
Its unique mechanism blocks neutrophil migration to inflamed joint. Efficacy is optimal if treatment begins within first 12 hours of attack.
Corticosteroids
Reserved for NSAID and colchicine contraindications, corticosteroids offer remarkable efficacy. Prednisolone (30-40mg/day for 5 days then tapering) is the reference protocol.
Background Uric Acid-Lowering Treatments
Xanthine Oxidase Inhibitors
Allopurinol remains first-line background treatment. Started at 100mg/day, dosage is gradually increased to achieve target uricemia below 60mg/L.
A 2024 PubMed study demonstrates 80% of patients reach therapeutic objective with 300mg/day allopurinol.
Natural and Complementary Approaches
Diet plays determining role in gout management. USDA FoodData Central data allows precise food purine content identification.
Foods to Avoid: Organ meats, anchovies, sardines, beer
Favorable Foods: Cherries, low-fat dairy, green vegetables, coffee