A 50-year-old male with a history of gout presents with acute onset severe pain, swelling, and redness in his left great toe. He reports no fever. He takes daily aspirin for cardiovascular prevention and has a history of peptic ulcer disease. What is the most appropriate initial treatment for his acute gout flare?

✓ Correct Answer: Option B

Given the patient's history of peptic ulcer disease, NSAIDs (like indomethacin) are relatively contraindicated. Oral prednisone is an effective alternative for acute gout flares when NSAIDs are not suitable or if colchicine is poorly tolerated or ineffective. Allopurinol is for chronic prophylaxis, not acute flares.