Treating acute gouty arthritis with selective COX 2 inhibitors

Description: Preliminary evidence supports their relative efficacy and safety
Few arthritides are as painful, incapacitating, and stressful as a severe attack of acute gout, pseudogout, or calcific periarthritis. Successful treatment of these acute microcrystalline events depends on early use of an effective and safe anti-inflammatory drug in full dosage. The sooner such treatment is started the more rapid and complete the response. Treatment options include colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids including adrenocorticotrophic hormone.
A recent randomised, double blind, eight day trial comparing etoricoxib 120 mg once daily with indomethacin 50 mg thrice daily in acute gout showed the two drugs to be equally efficacious, with etoricoxib showing an improved safety profile.9 The findings support a potential role for cyclo-oxygenase-2 inhibitors in managing acute gout, and raise important questions.
Treating acute gouty arthritis with selective COX 2 inhibitors. Fam AG. BMJ. 2002 Nov 2;325(7371):980-1.