Prednisone for Gout is my review of the use of steroids for acute gout pain. Also, I look at the evidence to support prednisone for gout pain prevention during early stages of uric acid treatment.
Prednisone for Gout Audience
I wrote Prednisone for Gout for Gout Patients who want to avoid gout pain during uric acid treatment. Because all forms of uric acid treatment take several months before the risk of gout attacks has gone. Also, reducing uric acid can trigger gout flares if partially dissolved crystals provoke our immune system.
Prednisone for Gout Facts
I summarized relevant scientific research in Prednisone and Gout Facts for Patients. But those reports both consider prednisone for gout during acute flare-ups.
When we want to end gout permanently, we have to reduce uric acid to safe levels. But as this takes time, we also need pain relief during the early months. So some doctors recommend daily preventative pain relief. Whereas others recommend pain relief as required. Now, this is very much a personal choice and you must discuss it with your doctor.
However, the question remains – is prednisone appropriate for preventative gout pain relief? Or is it only suitable for acute gout pain relief?
Prednisone for Gout Pain Prevention
For answers, we can turn to a comprehensive study of gout pain prevention. Note that the medical term for preventative care is prophylaxis.
In this report, Latourte and colleagues look at all common forms of gout pain prophylaxis. But they also look at less common forms. So they note that the first-line recommendation for gout pain prevention is colchicine or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs, e.g. naproxen). Then, in the section about steroids, they recommend that where colchicine and NSAIDs cannot be tolerated, low dose steroids are a suitable alternative for up to 6 months.
no trial has specifically evaluated low-dose steroids (<10 mg equivalent prednisone/day) for prophylaxis of Gout Flares. Low-dose prednisolone or prednisone is therefore recommended as second-line prophylactic treatment for patients with contraindications or intolerance to both NSAIDs and colchicine
The report continues with a warning about prednisone side-effects. In particular the worsening of diabetes.
Prednisone for Your Gout
Clearly, the best solution for your gout is to lower uric acid below 5mg/dL as soon as you can. Because that removes the need for long-term prednisone or any other form of pain relief. But, you must discuss your options with your doctor. Because prednisone is not appropriate for diabetics and also has adverse reactions with certain drugs.
Finally, various studies tell us that gout patients recover quicker where they have nurses or other mentors to discuss progress with. So if you do not get that service from your doctor, please discuss your gout treatment with other patients.
Prednisone for Gout References
- Latourte, Augustin, Thomas Bardin, and Pascal Richette. “Prophylaxis for acute gout flares after initiation of urate-lowering therapy.” Rheumatology 53, no. 11 (2014): 1920-1926. Gout Pain Prevention during Uric Acid Treatment PDF.