Oral steroids are an effective option for treating acute gout, according to a new study from Hong Kong. More than 400 patients with acute gout were randomized to indomethacin or prednisolone and followed for 2 weeks. Of the 376 patients who completed the study, the reductions in mean pain scores were similar, but indomethacin was associated with significantly more minor adverse events (19% vs 6%; P < 0.001). The authors concluded prednisolone is an effective and safe first-line option for the treatment of acute gout. This supports the American College of Rheumatology’s recent guideline on gout management that recommends oral corticosteroids in addition to nonsteroidal anti-inflammatory drugs and colchicine as first-line options for treatment of acute gout. This study strengthens that recommendation, providing a treatment option for those with renal insufficiency of gastrointestinal disease (Ann Intern Med Published online Feb. 23 2016. doi:10.7326/M14-2070).
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