Oral prednisolone versus non-steroidal anti-inflammatory drugs in the treatment of acute gout: a meta-analysis of randomized controlled trials
Oral prednisolone versus non-steroidal anti-inflammatory drugs in the treatment of acute gout: a meta-analysis of randomized controlled trials
复制标题
口服泼尼松龙与非甾体抗炎药治疗急性痛风：随机对照试验的荟萃分析
DOI：
10.1007/s10787-018-0442-8
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发表时间：
2018-01
影响因子：
5.8
通讯作者：
Xu Zhenghao
中科院分区：
文献类型：
--
作者：
Yu Jie;Lu Haimei;Zhou Jia;Xie Zhijun;Wen Chengping;Xu Zhenghao
ObjectivesTo evaluate the efficacy and safety of oral prednisolone in the treatment of acute gout compared with non-steroidal anti-inflammatory drugs (NSAIDs).MethodsA comprehensive search of databases in both Chinese and English was performed. Data from the selected studies were extracted and analyzed independently by two authors.ResultsThree double-blind, randomized, controlled trials were included in the final analysis, with a total of 584 patients. Regarding the efficacy, oral prednisolone (30–35 mg/day) was comparable with NSAIDs (naproxen at 500 mg/day or indomethacin at 50–100 mg/day) on the pain relief scale, both in activity (difference in means 0.259, 95% CI − 1.532 to 2.050,P= 0.777) and at rest (difference in means − 0.502, 95% CI − 4.961 to 3.956,P= 0.825) during the first 2–6 h. During the following 4 to 6 days, prednisolone acted with comparable efficacy either in activity (difference in means − 0.552, 95% CI − 1.364 to 0.260,P= 0.183) or at rest (difference in means − 0.164, 95% CI − 0.463 to 0.134,P= 0.281). Regarding safety, prednisolone did not increase the total adverse events (AEs) (risk ratios [RR] 0.765, 95% CI 0.473 to 1.238,P= 0.275) and reduced the withdrawal rate because of the AEs (RR 0.127, 95% CI 0.021–0.763,P= 0.024). Prednisolone decreased the risks of several AEs (including indigestion: RR 0.544, 95% CI 0.311–0.952,P= 0.033; nausea: RR 0.296, 95% CI 0.136–0.647,P= 0.002; and vomiting: RR 0.155, 95% CI 0.033–0.722,P= 0.018) but increased the risk of skin rashes (RR 4.049, 95% CI 1.241–13.158,P= 0.021).ConclusionsOral prednisolone may be of similar efficacy and a slightly safer strategy for treatment of active, acute gout compared with NSAIDs. Further clinical studies are still warranted to investigate its long-term efficacy and safety.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
6.2
作者：
Man CY;Cheung IT;Cameron PA;Rainer TH
通讯作者：
Rainer TH
影响因子：
8.4
作者：
H. Janssens;P. Lucassen;F. A. Laar;M. Janssen;E. Lisdonk
通讯作者：
H. Janssens;P. Lucassen;F. A. Laar;M. Janssen;E. Lisdonk
影响因子：
39.2
作者：
Rainer, Timothy Hudson;Cheng, Chi Hung;Graham, Colin Alexander
通讯作者：
Graham, Colin Alexander
影响因子：
0.4
作者：
Moher, David;Liberati, Alessandro;Altman, Douglas G.
通讯作者：
Altman, Douglas G.