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J Rheumatol. 1994 Apr;21(4):696-9.

ACTH revisited: effective treatment for acute crystal induced synovitis in patients with multiple medical problems.

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  • 1Department of Medicine, Mt. Sinai School of Medicine, New York, NY 10029.

Abstract

OBJECTIVE:

To determine the effectiveness of adrenocorticotropic hormone (ACTH) for acute gouty arthritis and pseudogout in a population of patients with multiple coexisting medical problems.

METHODS:

We retrospectively reviewed our experience with parenteral ACTH 40 or 80 units intravenous, intramuscular, or subcutaneous tid with tapering in the treatment of 38 patients. Thirty-three patients had documented acute gout and 5 patients had documented acute pseudogout. A total of 43 episodes of acute crystal induced synovitis were treated. The indications for using ACTH included congestive heart failure, chronic renal insufficiency, gastrointestinal bleeding, or no response to NSAID:

RESULTS:

All episodes of pseudogout resolved in an average of 4.2 days. Of the episodes of acute gout, 97% resolved in an average of 5.5 days. Although mild hypokalemia, hyperglycemia, fluid retention and rebound arthritis occurred as adverse effects, none was severe and all were easily controlled.

CONCLUSION:

ACTH is a safe and effective treatment for acute gout and pseudogout, especially in patients with multiple medical problems.

PMID:
8035395
[PubMed - indexed for MEDLINE]
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