Corticosteroid therapy for the treatment of acute attacks of crystal-induced arthritis: an effective alternative to nonsteroidal antiinflammatory drugs.
To evaluate glucocorticoids as an alternative to nonsteroidal antiinflammatory drugs in patients with crystal-induced arthritis, a study was conducted in 27 patients with acute attacks of gout or chondrocalcinosis. Patients with contraindications to nonsteroidal antiinflammatory drug therapy were given either a single intramuscular injection of 7 mg betamethasone (group B, n = 10) or, if they were receiving anticoagulant therapy, a single intravenous injection of 125 mg methylprednisolone (group C, n = 7). The remaining patients (group A, n = 10) were given diclofenac in a dosage of 150 mg per day for three days then 75 mg per day for three days. Efficacy was evaluated based on the self-evaluated subjective improvement (%) and on the severity of joint swelling on days 1, 3, and 6. Both parameters improved promptly in all three groups. C-reactive protein decreased between baseline and day 6. Few patients had relapses. Glucocorticoid therapy was well tolerated. Our data show that a single intramuscular or intravenous injection of a glucocorticoid is safe and effective in patients with crystal-induced arthritis and risk factors for intolerance to nonsteroidal antiinflammatory drugs.
Werlen
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Rheumatology Department, Cantonal University Hospital, Geneva, Switzerland.
Gabay
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C
Vischer
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TL
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D015210:Arthritis, Gouty / Q000175:diagnosis / Q000188:drug therapy*; D001623:Betamethasone / Q000008:administration & dosage; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002805:Chondrocalcinosis / Q000175:diagnosis / Q000188:drug therapy*; D004008:Diclofenac / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D004008:Diclofenac; D002097:C-Reactive Protein; D001623:Betamethasone; D008775:Methylprednisolone