Acute Gout Steroid Alternative — ESENeph MCQ

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EasyChronic Kidney DiseaseAcute Gout Steroid AlternativeESENeph

A 55-year-old man with CKD G3b develops acute gout. He cannot take Colchicine (previous intolerance) or NSAIDs (CKD + peptic ulcer). What is the most appropriate acute treatment?

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Correct answer: A — Short course of Prednisolone

When both NSAIDs and Colchicine are contraindicated, a short course of oral Prednisolone is an effective alternative for acute gout. NICE CG169 (Gout) and BSR guidelines recommend Prednisolone 15-20 mg daily for 5-7 days as an alternative. Intra-articular injection of corticosteroid is another option for monoarticular gout. Allopurinol and Febuxostat are urate-lowering therapies for prophylaxis and should not be started during an acute flare.

Reference: https://guidelines.ukkidney.org