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Steroid pill safe and effective first-line treatment for acute gout

An oral steroid had similar effectiveness to an oral non-steroid anti-inflammatory drug NSAID for improving pain in patients with acute gout, according to a trial published in Annals of Internal Medicine.

Recent double-blind randomized trials showed that both oral steroids and oral NSAIDs have similar pain-relieving effects in gout, but the trials were small and had other methodological limitations. In a multicenter trial, researchers compared the effectiveness and safety of oral prednisolone versus oral indomethacine in 416 adult patients with acute gout. Patients were randomly assigned to receive either prednisolone or indomethacine, with neither researchers nor patients knowing which medication was administered. Patients in both groups reported similar pain relief with no serious adverse events. The researchers conclude that oral steroids are a safe and effective first-line treatment for patients with acute gout.

Research: Oral Prednisolone in the Treatment of Acute Gout: A Pragmatic, Multicenter, Double-Blind, Randomized Trial, Timothy Hudson Rainer, MD* Chi Hung Cheng, MD* Hein J.E.M. Janssens, MD, PhD Chi Yin Man, MD Lai Shan Tam, MD Yu Fai Choi, MD Wah Hon Yau, MD Ka Hing Lee, MD and Colin Alexander Graham, MD, Annals of Internal Medicine, doi:10.7326/M14-2070, published online 23 February 2016.