From the Guidelines
For the treatment of gouty arthritis, the recommended dose of prednisone is 30-35 mg/day of equivalent prednisolone for 3-5 days. This dosage is based on the 2016 updated EULAR evidence-based recommendations for the management of gout, as published in the Annals of the Rheumatic Diseases in 2017 1. The goal of this treatment is to reduce inflammation and alleviate the painful symptoms of gout.
Key Considerations
- The choice of drug for acute flares of gout should be based on the presence of contraindications, the patient’s previous experience with treatments, time of initiation after flare onset, and the number and type of joint(s) involved.
- Colchicine and NSAIDs are also recommended as first-line options for acute flares, but they should be avoided in patients with severe renal impairment.
- Patients should be educated to self-medicate at the first warning symptoms of a gout attack, and treatment should be initiated as early as possible.
Potential Side Effects and Interactions
- While taking prednisone, patients should monitor for side effects such as increased blood sugar, mood changes, and fluid retention.
- Prednisone should be used cautiously in patients with diabetes, hypertension, or peptic ulcer disease.
- Concurrent use of colchicine or NSAIDs may be appropriate in some cases, but this should be discussed with a healthcare provider.
Long-Term Management
- After the acute attack resolves, patients should discuss preventive strategies and possibly urate-lowering therapy with their doctor to prevent future attacks.
- Lifestyle modifications, such as weight loss, avoidance of alcohol and sugar-sweetened drinks, and regular exercise, can also help reduce the risk of future gout attacks.
From the FDA Drug Label
The initial dosage of PredniSONE tablets may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated. IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT
The dose of prednisone for gouty arthritis is not explicitly stated in the provided drug label. However, the label does provide a general dosage range of 5 mg to 60 mg per day, depending on the specific disease entity being treated.
- The dosage requirements are variable and must be individualized based on the disease under treatment and the patient's response.
- The label recommends starting with an initial dosage and adjusting as needed to achieve a satisfactory response, then tapering to the lowest effective maintenance dose 2.
From the Research
Treatment Options for Gouty Arthritis
- The treatment of gout includes anti-inflammatory therapy and prophylaxis of flare-ups, as well as measures for long-term uric acid reduction 3.
- Acute arthritis urica is best relieved by intra-articular steroids, systemic steroids, NSAIDs, and in exceptional cases, colchicine 3.
- For the prophylaxis of relapses, long-term use of colchicine, NSAIDs, or low-dose steroids is an option 3.
Use of Corticosteroids
- Corticosteroids are a suitable option for the treatment of acute gouty arthritis, especially when NSAIDs or colchicine are contraindicated 4.
- Intra-articular glucocorticoids may be a safe and effective treatment for acute gout, although there is limited evidence to support their use in this setting 5.
Dose of Prednisone
- There is no specific information on the dose of prednisone for gouty arthritis in the provided studies.
- However, it is mentioned that low-dose steroids can be used for the prophylaxis of relapses 3, but the exact dose is not specified.