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Randomized Controlled Trial
. 2016 Mar 11:22:810-7.
doi: 10.12659/msm.895749.

Comparison of Prednisolone, Etoricoxib, and Indomethacin in Treatment of Acute Gouty Arthritis: An Open-Label, Randomized, Controlled Trial

Lingling Xu  1 , Shiqun Liu  1 , Meiping Guan  1 , Yaoming Xue  1
Affiliations
Randomized Controlled Trial

Comparison of Prednisolone, Etoricoxib, and Indomethacin in Treatment of Acute Gouty Arthritis: An Open-Label, Randomized, Controlled Trial

Lingling Xu et al. Med Sci Monit. .

Abstract

Background: At present there are several kinds of medicine for treating acute gout arthritis (AGA). This study compared the efficacy and safety of prednisolone, etoricoxib, and indomethacin in the treatment of AGA.

Material/methods: This was an open-label, randomized, active-comparator study in patients with AGA. Patients were randomized to 4 days of prednisolone 35 mg qd, etoricoxib 120 mg qd, or indomethacin 50 mg tid. The primary efficacy endpoint was the reduction of self-assessed pain in the index joint from baseline. Secondary endpoints included changes in physician's assessment of tenderness, erythema, swelling, and joint activity; patient assessment of response to therapy; and safety.

Results: We analyzed 113 patients. Baseline demographics were comparable among treatment groups. Oral prednisolone, etoricoxib, and indomethacin were similarly effective in improving pain, tenderness, and joint activity over 4 days. For inflammation, oral prednisolone, etoricoxib, and indomethacin were similarly effective in reducing erythema, but prednisolone might be more effective in reducing swelling than indomethacin. The patient response to therapy was similar in the 3 groups. There were more total adverse events with indomethacin compared with the other 2 drugs.

Conclusions: Efficacy was comparable among prednisolone, etoricoxib, and indomethacin for the treatment of AGA. Prednisolone might be more effective in reducing inflammation and it had a better safety profile.

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Figures

Figure 1
Figure 1
Patient flowchart.
Figure 2
Figure 2
(A) Mean change in pain of the index joint from baseline (primary endpoint). * P<0.001 vs. baseline of the same group. (B) Mean change in tenderness of the index joint from baseline. * P<0.001 vs. baseline of the same group. (C) Mean change in erythema of the index joint from baseline. * P<0.001 vs. baseline of the same group. (D) Mean change in swelling of the index joint from baseline. The decrease in the swelling index was better with prednisolone than with indomethacin (P=0.01). * P<0.001 vs. baseline of the same group. (E) Mean change in activity of the index joint from baseline. * P<0.001 vs. baseline of the same group.
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