Prednisolone Is as Effective as Naproxen for Acute Gout

In a recent study of patients with acute gout, oral prednisolone was as effective as — and better tolerated than — indomethacin (JW May 17 2007). Those findings suggested the following question: How does prednisolone compare with nonsteroidal anti-inflammatory drugs that might be less potent, but also less toxic, than indomethacin?

Dutch researchers randomized 120 patients with acute gouty arthritis and no contraindications to NSAIDs to receive either oral prednisolone (35 mg daily) or naproxen (500 mg twice daily) for 5 days. All patients were referred by primary care physicians within 24 hours of initial presentation, and monosodium urate crystals were identified in synovial fluid from a symptomatic joint in each patient. Prednisolone and …