ACTH revisited: effective treatment for acute crystal induced synovitis in patients with multiple medical problems.

Abstract

OBJECTIVE:

To determine the effectiveness of adrenocorticotropic hormone (ACTH) for acute gouty arthritis and pseudogout in a population of patients with multiple coexisting medical problems.

METHODS:

We retrospectively reviewed our experience with parenteral ACTH 40 or 80 units intravenous, intramuscular, or subcutaneous tid with tapering in the treatment of 38 patients. Thirty-three patients had documented acute gout and 5 patients had documented acute pseudogout. A total of 43 episodes of acute crystal induced synovitis were treated. The indications for using ACTH included congestive heart failure, chronic renal insufficiency, gastrointestinal bleeding, or no response to NSAID:

RESULTS:

All episodes of pseudogout resolved in an average of 4.2 days. Of the episodes of acute gout, 97% resolved in an average of 5.5 days. Although mild hypokalemia, hyperglycemia, fluid retention and rebound arthritis occurred as adverse effects, none was severe and all were easily controlled.

CONCLUSION:

ACTH is a safe and effective treatment for acute gout and pseudogout, especially in patients with multiple medical problems.

• Authors: J Ritter, L D Kerr, J Valeriano-Marcet, H Spiera
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 21 Issue 4 Pg. 696-9 (Apr 1994) ISSN: 0315-162X [Print] Canada
• PMID: 8035395 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adrenocorticotropic Hormone

Topics

• Adrenocorticotropic Hormone (adverse effects, therapeutic use)
• Aged
• Aged, 80 and over
• Arthritis, Gouty (complications, drug therapy)
• Chondrocalcinosis (complications, drug therapy)
• Female
• Gastrointestinal Hemorrhage (complications, drug therapy)
• Heart Failure (complications, drug therapy)
• Humans
• Hypokalemia (chemically induced)
• Kidney Failure, Chronic (complications, drug therapy)
• Male
• Recurrence
• Retrospective Studies
• Synovitis (drug therapy)