Format

Send to:

Choose Destination
See comment in PubMed Commons below
Semin Arthritis Rheum. 2014 Aug;44(1):31-8. doi: 10.1016/j.semarthrit.2014.02.003. Epub 2014 Feb 13.

Treatment of acute gout: a systematic review.

Author information

  • 1Division of Rheumatology, University of Michigan, 300 North Ingalls, 7D13, Ann Arbor, MI 48109-5422. Electronic address: pkhanna@umich.edu.
  • 2Emory University, Atlanta, GA.
  • 3Rochester General Health System, Rochester, NY.
  • 4David Geffen School of Medicine, UCLA, Los Angeles, CA.
  • 5Division of Rheumatology, University of Michigan, 300 North Ingalls, 7D13, Ann Arbor, MI 48109-5422.
  • 6Division of Rheumatology, University of Michigan, 300 North Ingalls, 7D13, Ann Arbor, MI 48109-5422; Taubman Health Science Library, University of Michigan, 300 North Ingalls, 7D13, Ann Arbor, MI 48109-5422.
  • 7VAMC/UCSD, La Jolla, CA.

Abstract

OBJECTIVE:

Acute gout is traditionally treated with NSAIDs, corticosteroids, and colchicine; however, subjects have multiple comorbidities that limit the use of some conventional therapies. We systematically reviewed the published data on the pharmacologic and non-pharmacologic agents used for the treatment of acute gouty arthritis.

METHODS:

A systematic search was performed using PubMed and Cochrane database through May 2013. We included only randomized controlled trials (RCTs) that included NSAIDs, corticosteroids, colchicine, adrenocorticotropic hormone (ACTH), interleukin-1 (IL-1) inhibitors, topical ice, or herbal supplements.

RESULTS:

Thirty articles were selected for systematic review. The results show that NSAIDs and COX-2 inhibitors are effective agents for the treatment of acute gout attacks. Systemic corticosteroids have similar efficacy to therapeutic doses of NSAIDs, with studies supporting oral and intramuscular use. ACTH is suggested to be efficacious in acute gout. Oral colchicine demonstrated to be effective, with low-dose colchicine demonstrating a comparable tolerability profile as placebo and a significantly lower side effect profile to high-dose colchicine. The IL-1β inhibitory antibody, canakinumab, was effective for the treatment of acute attacks in subjects refractory to and in those with contraindications to NSAIDs and/or colchicine. However, rilonacept was demonstrated to be not as effective, and there are no RCTs for the use of anakinra.

CONCLUSION:

NSAIDs, COX-2 selective inhibitors, corticosteroids, colchicine, ACTH, and canakinumab have evidence to suggest efficacy in treatment of acute gout.

Published by Elsevier Inc.

KEYWORDS:

Acute gout; Systematic review

PMID:
24650777
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk