A short course of a corticosteroid could supplant nonsteroidal anti-inflammatory drugs (NSAIDs) as the medication of choice to treat gout, Dutch researchers suggest.


In their clinical trial, prednisolone proved as effective as naproxen while averting the GI, renal, and cardiovascular complications that NSAIDs can cause. Hein J.E.M. Janssens, MD, of Radbound University Nijmegen Medical Center in the Netherlands and colleagues studied 120 gout patients. Half were randomly assigned to receive 35 mg prednisolone mg once a day for five days and the other half was given 500 mg of naproxen twice a day for five days.

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Using a visual analog scale that ranged from 0 mm to 100 mm, the researchers measured the patients’ pain. After 90 hours, the pain scores fell 44.7 mm in the prednisolone group and 46.0 mm in the naproxen group, “suggesting equivalence.” Adverse effects were similar, minor, and resolved within three weeks, the researchers reported in the Lancet (2008;371:1854-1860).


“The present study provides a strong argument to consider prednisolone as a first treatment option,” they conclude.