From the Guidelines
Prednisone for gout is typically prescribed at 30-35mg daily for 3-5 days, as recommended by the 2016 updated EULAR evidence-based recommendations for the management of gout 1. This dosage is based on the equivalent prednisolone dose, which has been shown to be effective in reducing pain and inflammation in patients with acute gout. The medication should be taken with food to minimize stomach irritation. Prednisone works by reducing inflammation and suppressing the immune response that causes gout pain and swelling. While taking prednisone, it's essential to avoid abruptly stopping the medication as this can cause withdrawal symptoms. Patients should also limit alcohol consumption and maintain adequate hydration. Common side effects include increased appetite, mood changes, and elevated blood sugar. Those with diabetes should monitor their glucose levels closely. For long-term gout management, medications like allopurinol or febuxostat are preferred as prednisone is best suited for acute flares due to its side effect profile with prolonged use. If symptoms don't improve within 48 hours of starting prednisone, medical reassessment is recommended. It's also important to note that corticosteroids, such as prednisone, should be considered as first-line therapy in patients without contraindications because they are generally safer and a low-cost treatment option, as stated in the American College of Physicians guideline on management of acute and recurrent gout 1.
From the Research
Gout Treatment Overview
- Gout is a common form of inflammatory arthritis that can be treated with various medications, including NSAIDs, corticosteroids, and colchicine 2, 3, 4.
- The treatment of acute gout attacks typically involves the use of NSAIDs, corticosteroids, or colchicine, with the goal of reducing pain and inflammation 2, 3, 5.
Prednisone Dose for Gout
- While the provided studies do not specifically mention the use of prednisone for gout, they do discuss the use of systemic corticosteroids, which are a class of medications that includes prednisone 2.
- Systemic corticosteroids have been shown to be effective in treating acute gout attacks, with studies supporting oral and intramuscular use 2.
- However, the optimal dose of prednisone for gout is not specified in the provided studies, and further research would be needed to determine the most effective dose.
Alternative Treatment Options
- Other treatment options for gout include colchicine, which has been shown to be effective in reducing pain and inflammation, especially when used at low doses 5.
- Urate-lowering therapy, such as allopurinol or febuxostat, may also be used to prevent gout flares, especially in patients with chronic kidney disease or other comorbidities 3, 4, 6.
- Lifestyle modifications, such as dietary changes and weight loss, may also be recommended to help manage gout symptoms and prevent flares 4, 6.