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Intra-articular glucocorticoids for acute gout

Creator:

Wechalekar, M.D., et al

Subject Keywords: Safety, Efficacy, Intra-articular glucocorticoids, Treatment, Acute gout
Type: Article
Region: International (other)
Description:

This summary of a Cochrane review presents what we know from research about the effect of glucocorticoid injections (into affected joints) in people with acute gout. There were no trials that met our inclusion criteria, and no trials measuring the effect on pain, inflammation, the number of withdrawals due to adverse events, function, quality of life, treatment success and serious adverse events. Studies of glucocorticoid injections in other conditions that lead to joint pain suggest that this therapy may be well tolerated, relatively safe and effective in relieving pain.

What is gout, and what are intra-articular glucocorticoids?

Gout is a disease caused by high uric acid levels in the blood leading to crystal formation in the joints. People with gout can have flares of extremely painful, warm, red and swollen joints, usually in the big toe, ankle or knee. Gout usually presents as acute attacks causing joint swelling and pain but also can lead to chronic arthritis. While there is no cure for the disease, treatment can prevent recurrent gout attacks and improve its chronic form. Acute attacks may be provoked by trauma, ingesting certain medications (for example diuretics), hospitalisation, alcohol use and surgery.

Intra-articular glucocorticoids are a medication that is injected into joints; glucocorticoids are man-made drugs that closely resemble cortisol, a hormone that is produced by the adrenal glands. Oral pain or anti-inflammatory medications are usually used to treat acute gout. Intra-articular glucocorticoids are used if the usual medications don't work or if people are unable to take the usual medications because of other health problems.

While we were unable to find any controlled trials that have compared intra-articular glucocorticoids to placebo or another treatment, trials of intra-articular glucocorticoids for other conditions including osteoarthritis (some of which include people who have other types of crystals in their joints) and rheumatoid arthritis have found that this treatment is effective and safe. It is likely that these results would be generalisable to people with acute gout.

Date:

30/04/2013

Rights: © The Cochrane Collaboration
Suggested citation:

Wechalekar, M.D., et al. (2013) Intra-articular glucocorticoids for acute gout [Online]. Available from: http://publichealthwell.ie/node/479828 [Accessed: 17th October 2019].

  

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