Comparison of adrenocorticotropic hormone and triamcinolone acetonide in the treatment of acute gouty arthritis.

Abstract

OBJECTIVE:

To determine the best alternative therapy for acute gouty arthritis when nonsteroidal antiinflammatory drugs or colchicine are contraindicated.

METHODS:

Thirty-one patients with crystal proven gout presenting with an acute attack of < 5 days' duration were treated prospectively with either a single intramuscular injection of adrenocorticotropic hormone (ACTH) 40 IU or triamcinolone acetonide 60 mg. The patients were followed for 30 days.

RESULTS:

Resolution of all symptoms occurred at an average of 8 days for both groups. No adverse reactions were noted in either group; however, there were 11 reinjections in the ACTH group and 5 reinjections in the triamcinolone acetonide group. Two patients from the ACTH arm were transferred to the triamcinolone acetonide arm because of rebound arthritis.

CONCLUSION:

Although recent studies of ACTH and triamcinolone acetonide have demonstrated efficacy and safety comparable to indomethacin, in a direct comparison of the 2 at the doses used, triamcinolone acetonide resulted in fewer rebound attacks and treatment failures than ACTH and required fewer reinjections.

• Authors: L B Siegel, J A Alloway, D J Nashel
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 21 Issue 7 Pg. 1325-7 (Jul 1994) ISSN: 0315-162X [Print] Canada
• PMID: 7966077 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Adrenocorticotropic Hormone
• Triamcinolone Acetonide

Topics

• Acute Disease
• Adrenocorticotropic Hormone (administration & dosage, therapeutic use)
• Aged
• Arthritis, Gouty (drug therapy)
• Humans
• Injections, Intramuscular
• Male
• Middle Aged
• Prospective Studies
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage, therapeutic use)