"Serum uric acid levels can be normal or low at the time of acute attack. This limits the value of serum uric acid determination for the diagnosis of gout. Nevertheless, serum urate levels are almost always elevated at some time & are important to use to follow the course of hyperuricemic therapy". — Harrison 17th /e 2166Colchicine is the fastest acting drug. However it is reserved for the patients in which NSAIDs are condraindicated, because colchicine can cause gastrointestinal disturbances. Allopurinol and uricosuric drugs (sulfinpyrazone, probenacid) are not effective in acute gout because they will not relieve symptoms as they don't have anti-inflammatory property.