From the Guidelines
For a gout flare, prednisone should be prescribed at a dose of 30-35 mg/day of equivalent prednisolone for 3-5 days. This recommendation is based on the 2016 updated EULAR evidence-based recommendations for the management of gout 1. The choice of drug 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. Some key points to consider when treating gout flares with prednisone include:
- The importance of treating acute flares as early as possible
- The need for fully informed patients to be educated to self-medicate at the first warning symptoms
- The potential for combination therapy, such as colchicine and an NSAID or colchicine and corticosteroids, for patients with particularly severe acute gout
- The need to avoid colchicine and NSAIDs in patients with severe renal impairment
- The importance of considering the patient’s medical history and other medications when selecting a treatment option. It's also important to note that while taking prednisone, patients should rest the affected joint, apply ice for 20-30 minutes several times daily, and stay well-hydrated. If the patient has diabetes, prednisone may increase blood sugar levels, so more frequent monitoring is recommended 1.
From the Research
Dose of Prednisone for Gout Flare
- The dose of prednisone for gout flare is not explicitly stated in the provided studies, but one study 2 mentions that participants in the intervention group receive 30 mg prednisolone for 5 days.
- It is essential to note that prednisolone and prednisone are similar medications, but they are not identical, and the dosage may vary depending on the specific medication and the patient's condition.
- Other studies 3, 4, 5 discuss the treatment of acute gout with various medications, including non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, and glucocorticoids, but do not provide specific information on the dose of prednisone for gout flare.
- Study 6 focuses on colchicine concentrations and their relationship with colchicine efficacy and adverse events, but does not mention prednisone or its dosage for gout flare.