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 antiinfl ammatory drugs in patients with crystal-induced arthritis, a study was conducted in 27 patients with acute attacks of gout or chondrocalcino sis. Patients with contraindications to nonsteroidal antiinflammatory drug therapy were given either a single intramuscular injection of 7 m g betamethasone (group B, n=10) or, if they were receiving anticoagula nt therapy, a single intravenous injection of 125 mg methylprednisolon e (group C, n=7). The remaining patients (group A, n=10) were given di clofenac in a dosage of 150 mg per day for three days then 75 mg per d ay for three days. Efficacy was evaluated based on the self-evaluated subjective improvement (%) and on the severity of joint swelling on da ys 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 sho w that a single intramuseular or intravenous injection of a glucocorti coid is safe and effective in patients with crystal-induced arthritis and risk factors for intolerance to nonsteroidal antiinflammatory drug s.