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    Key clinical point: Oral prednisolone is as effective as indomethacin for relieving pain in acute gout and should be considered a first-line treatment option. Major finding: VAS scores declined during days 1-14 of treatment by similar mean amounts both at rest (1.80 mm/day for indomethacin and 1.68 mm/day for prednisolone) and with activity (2.96 mm/day vs. Data source: A multicenter, double-blind, randomized clinical trial involving 416 patients presenting to an ED for acute gout. Disclosures: This trial was supported by the Hong Kong government’s Health and Health Services Research Grant Committee. Rainer and his associates reported having no relevant financial disclosures. Oral prednisolone is as effective as indomethacin for relieving pain in acute gout and should be considered a first-line treatment option, according to a report published online Feb. Colchicine and nonsteroidal anti-inflammatory drugs have been considered the first-line treatment for acute gout for many years. “However, their use is limited in elderly adults and in patients with comorbid conditions (such as renal insufficiency or gastrointestinal disease) because of their potential adverse effects and drug interactions,” said Dr. Timothy Hudson Rainer of the emergency medicine academic unit, Cardiff (Wales) University, and his associates. They performed a double-blind, randomized trial comparing oral indomethacin against oral prednisolone in 416 patients who presented during a 2-year period to the emergency departments of four Hong Kong hospitals, where acute gout typically is treated in the ED. Treatment of gout flares - UpToDate Prednisone As Gout Treatment Gout Treatment Prednisone for other leading corticosteroids for pain relief.
     
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