From the Guidelines
The treatment of acute gouty arthritis typically involves the use of corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to reduce pain and inflammation, as recommended by the American College of Physicians 1.
Treatment Options
- Corticosteroids: such as prednisolone at a dose of 35 mg for 5 days, are considered a first-line therapy in patients without contraindications due to their effectiveness and lower cost 1.
- NSAIDs: such as indomethacin or naproxen, are also effective in reducing pain and inflammation, but may have adverse effects such as gastrointestinal issues 1.
- Colchicine: at a loading dose of 1 mg followed by 0.5 mg on day 1, is another option for treating acute gout, but may have gastrointestinal side effects 1.
Considerations
- The choice of treatment should be based on the presence of contraindications, patient's previous experience with treatments, and the number and type of joints involved 1.
- Patients with contraindications to NSAIDs or colchicine may be considered for corticosteroids or other alternative treatments 1.
- It is essential to educate patients on the importance of early treatment and self-medication at the first warning symptoms of an acute gout attack 1.
From the FDA Drug Label
In patients with acute gout, a favorable response to naproxen was shown by significant clearing of inflammatory changes (e.g., decrease in swelling, heat) within 24 to 48 hours, as well as by relief of pain and tenderness. Indomethacin capsules have been found effective in relieving the pain, reducing the fever, swelling, redness, and tenderness of acute gouty arthritis PredniSONE Tablets are indicated for the treatment of acute gouty arthritis as adjunctive therapy for short-term administration.
The treatment for acute gouty arthritis includes naproxen 2, indomethacin 3, and prednisone 4 for short-term administration to relieve pain, reduce inflammation, and manage symptoms.
From the Research
Treatment Options for Acute Gouty Arthritis
The treatment for acute gouty arthritis includes several options, such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) 5, 6, 7, 8
- Colchicine 5, 6, 7
- Corticosteroids 5, 6, 7
- Adrenocorticotropic hormone (ACTH) 6, 7
- Interleukin-1 (IL-1) inhibitors, such as canakinumab 6, 9
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are the most widely prescribed drugs for the treatment of acute gout 5, 8. They are effective in reducing pain and inflammation, but may have adverse effects, such as gastrointestinal bleeding and renal insufficiency 5, 8. The choice of NSAID should be based on the patient's comorbidities and pharmacokinetic properties 5.
Colchicine
Colchicine is an effective treatment for acute gout, but may have adverse effects, such as gastrointestinal toxicity 5, 6, 7. The dosage and administration schedule of colchicine should be carefully considered to minimize adverse effects 5.
Corticosteroids
Corticosteroids are a reasonable choice for patients who are unable to use NSAIDs or colchicine 5, 6, 7. They can be administered systemically or intra-articularly, and are effective in reducing pain and inflammation 6, 7.
Interleukin-1 (IL-1) Inhibitors
IL-1 inhibitors, such as canakinumab, are effective in treating acute gouty arthritis, particularly in patients who are unable to use NSAIDs or colchicine 6, 9. Canakinumab has been shown to provide rapid and effective pain relief and prolonged suppression of flares and inflammation 9.