Abstract

COSTA, Ana Margarida  and  SILVA, Ana Isabel Ribeiro da. Use of systemic corticosteroids in the treatment of acute gouty arthritis: what is the evidence?. Rev Port Med Geral Fam [online]. 2019, vol.35, n.5, pp.401-407. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i5.12293.

Aim: To evaluate the efficacy and safety of systemic corticosteroids (SC) in the treatment of acute gouty arthritis (AGA) and its benefits to classic treatment namely colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs). Data Sources: MEDLINE and evidence-based medicine sites. Review methods: Clinical guidelines (NOC), systematic reviews (RS), randomized controlled trials (RCT) and meta-analyses (MA), published between June 2007 and June 2017, using the MeSH terms glucocorticoids, gout suppressants, adrenal cortex hormones, acute disease, gout, and hyperuricemia. To assess the level of evidence, the American Family Physician's Strenght of Recommendation Taxonomy (SORT) was applied. Results: Of a total of 731 articles, eight NOC, two RS and two RCT were selected. NOC report an improvement in the symptomatology of AGA with the use of SC, NSAIDs or colchicine, differing in recommendations for the most appropriate first-line therapy. If on the one hand, some studies mention a more significant improvement of the symptoms with the use of SC, especially in the first days of treatment, on the other hand, they mention them as effective as the classic treatment. In general, all of them report more side effects in NSAID-treated patients compared to SC. Conclusions: SC, NSAIDs, and colchicine are all effective in the therapeutic management of AGA. However, SC is superior to NSAIDs in terms of safety. Thus, the choice of agent for AGA treatment should be determined based on the patient's profile.

Keywords : Gout; Glucocorticoids.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )