Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is the determine whether or not, “oral steroids are as effective as NSAIDS in relieving patient pain from gout?”

STUDY DESIGN: Review of three English language primary studies, published between 2008 and 2016.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using PubMed and Embase database. These studies analyzed the effectiveness of steroids in relieving patient pain from gout.

OUTCOMES MEASURED: The major outcomes measured were improvements in joint tenderness on palpation, joint erythema, joint swelling, and joint activity measured on a 5-point Likert scale. (0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain, 4=extreme pain). Analgesic effectiveness was measured as changes in pain on a 100-mm visual analogue scale. With 1 being the least pain the patient has ever experiences and 100 being the worst.

RESULTS: All three studies showed comparable efficacy between prednisolone and NSAIDS in treating gout. The Xu et al study concluded similar results between NSAIDS and Prednisolone in improving pain, tenderness, and joint activity. Furthermore, the study also stated Prednisolone may be more effective in reducing inflammation and was better tolerated. The Rainer et al and Janssen et al study found prednisolone and indomethacin have similar analgesic effectiveness, and prednisolone is a safe, and effective first line option for gout treatment.

CONCLUSION: The results of all three RCT’s which compared the efficacy between prednisolone and NSAIDS in the treatment of gout concluded similar results between the two groups. Therefore, proving steroids as an effective treatment option for patients diagnosed with gout.

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