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Steroid Pill May Ease Gout Attack

May 30, 2008 -- To treat gout attacks, prednisolone pills may be as good as the nonsteroidal anti-inflammatory drug naproxen.

That's according to a new Dutch study of 120 gout patients.

Nonsteroidal anti-inflammatory drugs ( NSAIDs) are the first drug of choice to treat gout, but NSAIDs have gastrointestinal and cardiovascular risks, note the researchers, who included Hein Janssens, MD, of Radboud University Nijmegen Medical Centre.

"As a consequence, safer therapeutic approaches are needed," Janssens' team writes in The Lancet. The researchers also say that although long-term steroid use is linked to serious side effects, steroids "do not have important drawbacks" when used short term.

Janssens' study is a head-to-head comparison of the oral steroid prednisolone and naproxen during gout attacks.

The patients, who had no history of heart problems or upper gastrointestinal diseases, were divided into two groups. One group took prednisolone for five days when a gout attack struck. The other patients took naproxen for five days when they had a gout attack. None of the patients knew which drug they were taking.

In diaries, the patients rated their gout pain and disability while taking their assigned drug. They were also interviewed by phone three weeks later.

Prednisolone and naproxen were equally effective at easing gout attack symptoms. Both drugs also had similar side effects, which were minor and temporary, the study shows.

The study "will go some way" to show that short-term treatment with oral steroids is as effective as NSAID treatment in treating gout attacks, states an editorial published with the study.

But the editorialists, who included Timothy H. Rainer, MD, of Hong Kong's Prince of Wales Hospital, aren't ready to rewrite treatment guidelines for gout attacks. They write that further research should be done because the Dutch study was "fairly small" and was done in one center.