Oral steroid safe and effective first-line treatment for gout, according to new study

A new trial, published in Annals of Internal Medicine, has found that an oral steroid had similar effectiveness to an oral non-steroid anti-inflammatory drug (NSAID) for improving pain in patients with acute gout.

Using two double-blind randomised, controlled trials, it was shown that oral steroids and NSAIDs have similar analgesic effectiveness for management of gout, although the trials were small and had other methodological limitations.

In a multicentre trial, researchers compared the effectiveness and safety of oral prednisolone versus oral indomethacin in 416 adult patients with acute gout. For the trial, participants were randomly assigned to receive either prednisolone or indomethacin, and neither the trial researchers or patients knew which medication was being administered.

The researchers found that both groups of patients reported similar pain relief, with no serious adverse events. They concluded that oral prednisolone and indomethacin had similar analgesic effectiveness among patients with acute gout. Prednisolone is an effective and safe first-line option for treatment of acute gout.

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