Xu Lingling, Liu Shiqun, Guan Meiping, Xue Yaoming
Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2016 Mar 11;22:810-7. doi: 10.12659/msm.895749.
At present there are several kinds of medicine for treating acute gout arthritis (AGA). This study compared the efficacy and safety of prednisolone, etoricoxib, and indomethacin in the treatment of AGA.
MATERIAL/METHODS: This was an open-label, randomized, active-comparator study in patients with AGA. Patients were randomized to 4 days of prednisolone 35 mg qd, etoricoxib 120 mg qd, or indomethacin 50 mg tid. The primary efficacy endpoint was the reduction of self-assessed pain in the index joint from baseline. Secondary endpoints included changes in physician's assessment of tenderness, erythema, swelling, and joint activity; patient assessment of response to therapy; and safety.
We analyzed 113 patients. Baseline demographics were comparable among treatment groups. Oral prednisolone, etoricoxib, and indomethacin were similarly effective in improving pain, tenderness, and joint activity over 4 days. For inflammation, oral prednisolone, etoricoxib, and indomethacin were similarly effective in reducing erythema, but prednisolone might be more effective in reducing swelling than indomethacin. The patient response to therapy was similar in the 3 groups. There were more total adverse events with indomethacin compared with the other 2 drugs.
Efficacy was comparable among prednisolone, etoricoxib, and indomethacin for the treatment of AGA. Prednisolone might be more effective in reducing inflammation and it had a better safety profile.
目前有多种药物用于治疗急性痛风性关节炎（AGA）。本研究比较了泼尼松龙、依托考昔和吲哚美辛治疗AGA的疗效和安全性。
材料/方法：这是一项针对AGA患者的开放标签、随机、活性对照研究。患者被随机分为三组，分别接受为期4天的泼尼松龙35毫克每日一次、依托考昔120毫克每日一次或吲哚美辛50毫克每日三次治疗。主要疗效终点是与基线相比，患者自我评估的受累关节疼痛减轻情况。次要终点包括医生对压痛、红斑、肿胀和关节活动的评估变化；患者对治疗反应的评估；以及安全性。
我们分析了113例患者。各治疗组的基线人口统计学特征具有可比性。口服泼尼松龙、依托考昔和吲哚美辛在4天内改善疼痛、压痛和关节活动方面效果相似。对于炎症，口服泼尼松龙、依托考昔和吲哚美辛在减轻红斑方面效果相似，但泼尼松龙在减轻肿胀方面可能比吲哚美辛更有效。三组患者对治疗的反应相似。与其他两种药物相比，吲哚美辛的总不良事件更多。
泼尼松龙、依托考昔和吲哚美辛治疗AGA的疗效相当。泼尼松龙在减轻炎症方面可能更有效，且安全性更好。
