Prednisolone as First-Line Treatment Option for Gout

Although American College of Rheumatology guidelines support the use of oral corticosteroids as well as nonsteroidal anti-inflammatory agents (NSAIDs) and colchicine for acute gout, the recommendation was based on small trials and might not be widely accepted. To compare the effectiveness of a corticosteroid and an NSAID, researchers at four Hong Kong emergency departments (EDs) randomized 416 adults (mean age, 65 years) presenting with acute gout to receive oral indomethacin (50 mg 3 times daily for 2 days, then 25 mg 3 times daily) or prednisolone (30 mg once daily) for 5 days.

In all but three patients, gout was diagnosed based on clinical criteria. Patients assessed joint pain on a 100-mm visual analog scale at baseline and every 30 minu…