Oral Prednisolone as Effective as, and Better Tolerated Than, Indomethacin for Gout

In a 2007 double-blind, randomized trial of 90 patients with acute gouty arthritis, prednisolone was as effective as — and much better tolerated than — the nonsteroidal anti-inflammatory drug (NSAID) indomethacin (NEJM JW Gen Med May 15 2007 and Ann Emerg Med 2007; 49:670). Now, the same research team has conducted a larger, but otherwise similar, study; 416 patients received either prednisolone (30 mg daily for 5 days) or indomethacin (50 mg thrice daily for 2 days, followed by 25 mg thrice daily for 3 days). Patients with active cardiac disease, glomerular filtration rate <30 mL/minute/1.73 m², or history of gastrointestinal bleeding were excluded.

During 14 days of follow-up, reductions in pain scores were similar in the prednisolone and …