From the Guidelines
For gouty arthritis, prednisone is typically prescribed at a dose of 35 mg for 5 days, as this regimen has been successfully used to treat acute gout 1.
Key Considerations
- The dose of prednisone may vary depending on the severity of the attack and the patient's medical history.
- Prednisone should be taken with food to minimize gastrointestinal side effects.
- Patients should monitor for side effects such as increased blood sugar, mood changes, and fluid retention while taking prednisone.
- Prednisone should be used cautiously in patients with diabetes, hypertension, or peptic ulcer disease.
Treatment Duration and Tapering
- The treatment duration for prednisone in gouty arthritis is typically 5 days, as recommended by the American College of Physicians 1.
- However, some clinicians may use a tapering regimen over 7-14 days, especially for severe attacks.
Alternative Regimens
- Other regimens, such as oral methylprednisolone dose packs or intramuscular triamcinolone acetonide, may be considered as alternative options 1.
- However, the use of these regimens should be based on individual patient needs and preferences.
Preventive Therapy
- Once the acute attack resolves, preventive therapy with medications like allopurinol or febuxostat may be recommended to lower uric acid levels and prevent future attacks 1.
From the Research
Dose of Prednisone for Gouty Arthritis
- The ideal dose of prednisone for gouty arthritis is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, it is mentioned that oral corticosteroids, such as prednisone, are valuable and relatively safe alternate treatment modalities for acute gouty arthritis, particularly in patients with polyarticular attacks 3.
- The studies suggest that systemic corticosteroids, including prednisone, have similar efficacy to therapeutic doses of NSAIDs for the treatment of acute gout attacks 5, 6.
- Intra-articular corticosteroid therapy, such as methylprednisolone acetate, is also indicated for the treatment of acute mono or oligoarticular gouty arthritis in aged patients and those with comorbid conditions contraindicating therapy with either NSAIDs or colchicine 3.
- The use of corticosteroids, including prednisone, is recommended as part of the treatment regimen for acute gouty arthritis, but the specific dose is not provided in the studies 2, 4, 5, 6.