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Oral corticosteroids are an alternative to nonsteroidal anti-inflammatory drugs (NSAIDs) for treatment of acute gouty arthritis. However, clinical trials have not compared these two treatments directly. This randomized double-blind trial from Hong Kong included 90 patients (mean age, 65) with acute “goutlike arthritis” (i.e., crystal confirmation or classic podagra without crystal confirmation). Patients received either indomethacin (50 mg 3 times daily for 2 days, then 25 mg 3 times daily for 3 days) or prednisolone (30 mg daily for 5 days).
During 14 days of follow-up, pain resolved at a similar rate in the two groups. However, the incidence of adverse events was significantly higher in the indomethacin group than in the prednisolone group…