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NSAIDS for Acute Gout?

How do NSAIDS stack up to COX inhibitors and glucocortocoids in acute gout? This article summarizes a Cochrane review of 23 trials involving 2200 patients.

van Durme CG, Wechalekar MD, Landewé RM. JAMA. Clinical Evidence Synopsis: Nonsteroidal Anti-inflammatory Drugs for Treatment of Acute Gout. JAMA. June 9, 2015. 2015;313(22):2276-2277. doi:10.1001/jama.2015.1881.


Moderate-quality evidence showed that the pain reduction of non-steroidal anti-inflammatory drugs (NSAIDs) was similar to cyclooxygenase (COX) inhibitors and glucocorticoids for acute gout.

However, NSAIDs were associated with higher rates of adverse events than COX inhibitors.

This article summarizes a Cochrane review of 23 clinical trials involving 2,200 patients.

The European League Against Rheumatism and the American College of Rheumatology guidelines recommend colchicines, NSAIDs, COX inhibitors, or glucocorticoids.

The review suggests that COX inhibitors may be preferred over NSAIDs because of lower toxicity.

However, there are no trials directly comparing NSAIDs to colchicines and COX inhibitors to glucocorticoids.