Canakinumab was found to be superior to other anti-inflammatories and intravenous (IV) or intramuscular (IM) corticosteroids may be the following best option for pain relief in patients suffering from gout flare. Swelling of the joint and patient global assessment can be improved with the help of acetic acid derivative NSAIDs, as concluded from a systematic review and network meta‐analysis in ‘Arthritis Care and Research’.

The effectiveness of pharmacological anti‐inflammatory therapies for gout flares has been explored in this study.

The databases- Ovid Medline, Embase and Cochrane library were searched for randomized controlled trials (RCTs) concerning pharmacological anti‐inflammatory therapies of gout flares. The frequentist framework was used to conduct the network meta‐analysis (NMA). Later, GRADE was used to assess the surety of evidence and create deductions.

Canakinumab provided the highest pain reduction at day 2 and at longest follow‐up in the 30 eligible RCTs. IV or IM corticosteroids was inferior as compared to canakinumab but may be better than other frequently used therapies (low to very low certainty). At day 2, canakinumab may be the most effective therapy concerning joint tenderness. Also, acetic acid derivative NSAIDs improved joint swelling better than profen NSAIDs (Mean difference [MD] ‐0.29 on a 0 to 4 scale; moderate certainty) and improved patient global assessment (PGA) better than profen NSAIDs at the lengthiest follow‐up (MD ‐0.44; moderate).