Which statement about NSAIDs in gout management is true?

• A. They are used for chronic gout only
• B. They are used for acute gout attacks
• C. They are not recommended
• D. They are used as urate-lowering therapy

Answer: (B)

NSAIDs are used to treat acute gout attacks because they rapidly reduce inflammation and pain caused by urate crystal–induced joint inflammation. They do this by inhibiting cyclooxygenase enzymes, which lowers prostaglandin production and dampens the inflammatory response in the affected joint. They provide quick relief during an acute flare, which is the primary reason they’re chosen in this setting. They do not lower serum uric acid levels, so they’re not used for chronic management of gout or as urate-lowering therapy. Chronic control focuses on medications like allopurinol or febuxostat to reduce uric acid, with NSAIDs reserved for short-term use during acute flares (and sometimes briefly for flare prophylaxis when starting urate-lowering therapy).