A Potential New Treatment for Acute Gout

Oral steroids appeared effective in treating acute gout in emergency room

(RxWiki News) An acute attack of gout can be extremely painful. But there may be a quick and effective treatment on the horizon.

A new study from Hong Kong found that an oral steroid medication was as effective in treating acute gout as the standard treatment.

Timothy Hudson Rainer, MD, an emergency medicine specialist at Cardiff University in the United Kingdom, led this study.

Gout is a very painful form of arthritis caused by high levels of a chemical called uric acid. It typically strikes one joint but may strike more than one. Scientists don't know exactly why uric acid levels build up in the blood.

Men, older people and those who drink alcohol may have a raised risk of gout. The condition may also run in families. Diabetes, obesity, kidney disease and some blood disorders may increase the risk of gout.

Indomethacin (brand name Indocin) has been the standard of care for many years, but it may have serious side effects, and some people can't take it.

Dr. Rainer and colleagues studied 416 patients who went to the emergency room with symptoms of acute gout.

Past research had suggested that oral steroids might be effective, but these studies had limitations. This study was designed to provide a clearer answer.

These researchers monitored patients in the emergency room and for 14 days afterward. Patients were randomly assigned to receive either indomethacin or oral prednisolone (brand names Prelone, Cotolone and Orapred), a type of oral steroid often used to treat inflammation, severe allergies, asthma, arthritis and other conditions. Patients' pain levels were assessed several times in the emergency room and at least daily for the next two weeks.

Dr. Rainer and team found that oral steroids appeared to reduce patients' reported pain levels just as much as indomethacin. 

Patients treated with indomethacin had more side effects than patients treated with oral steroids while in the emergency room. Over the two-week follow-up, side effects from both medications were about the same.

This study was published in the February issue of the Annals of Internal Medicine.

The Health and Health Services Research Grant Committee of the Hong Kong Government funded this research. Dr. Rainer and co-author Dr. Colin A. Graham received grant funding from the Health and Health Services Research Grant Committee.

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Review Date: 
February 27, 2016