Oral prednisolone versus non-steroidal anti-inflammatory drugs in the treatment of acute gout: a meta-analysis of randomized controlled trials

Gout is a form of inflammatory arthritis with an estimated prevalence of 1% of adults Worldwide. The number of previous reviews suggested the corticosteroids over the NSAIDs for the treatment of gout without focusing on the specific type of corticosteroids. The present study showed that the prednisolone has similar efficacy and safer therapy for active, acute gout compared with NSAIDs.

To calculate the safety and efficacy of oral prednisolone in the management of acute gout than with non-steroidal anti-inflammatory drugs (NSAIDs).  

The database was searched comprehensively in English and Chinese languages. Two authors extracted and analysed data from the selected studies independently.

The final analysis involved three double-blind, randomised, controlled trials comprised 584 patients. NSAIDs (50–100 mg/day Indomethacin or 500 mg/day Naproxen) and 30–35 mg/day oral Prednisolone exhibited similar efficacy regarding pain relief, both in activity and at rest during the first 2–6 h. Further, no total adverse events (AEs) were increased among the Prednisolone group and exhibited decreased withdrawal rate. Also, Prednisolone reduced the risks of several Aes such as vomiting, indigestion, and nausea but enhanced the risk of skin rashes.

Oral Prednisolone exhibits similar efficacy and a slightly safer strategy for acute gout management compared with NSAIDs. However, more clinical analysis is needed to determine Prednisolone's long-term safety and efficacy.