Prednisolone Deemed Safe, Effective First-Line Acute Gout Prescription

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For patients with acute gout, prednisolone has similar analgesic effectiveness to indomethacin.
For patients with acute gout, prednisolone has similar analgesic effectiveness to indomethacin.

HealthDay News -- For patients with acute gout, prednisolone has similar analgesic effectiveness to indomethacin, according to a study published in the Annals of Internal Medicine.

Timothy Hudson Rainer, MD, from the Chinese University of Hong Kong, and colleagues compared the effectiveness and safety of oral prednisolone versus oral indomethacin in patients presenting to emergency departments with acute gout. A total of 376 patients, aged 18 years or older, were randomized to receive either indomethacin or prednisolone. Patient outcomes were assessed during the first 2 hours in the emergency department and from days 1 to 14.

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The researchers observed equivalent and clinically significant within-group reductions in the mean pain score with indomethacin and prednisolone in the emergency department and from days 1 to 14. 

During the study there were no major adverse events. Patients in the indomethacin group had more minor adverse events during the emergency department phase than patients in the prednisolone group (19 versus 6%; P < 0.001). Thirty-seven percent of patients in each group had minor adverse events during days 1 to 14.

"Oral prednisolone and indomethacin had similar analgesic effectiveness among patients with acute gout," the authors write. "Prednisolone is an effective and safe first-line option for treatment of acute gout."

Reference

Rainer T, Cheng C, Janssens H, et al. Oral Prednisolone in the Treatment of Acute Gout. Ann Intern Med. 2016. doi:10.7326/m14-2070.

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