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  • Title: Comparison of adrenocorticotropic hormone and triamcinolone acetonide in the treatment of acute gouty arthritis.
    Author: Siegel LB, Alloway JA, Nashel DJ.
    Journal: J Rheumatol; 1994 Jul; 21(7):1325-7. PubMed ID: 7966077.
    Abstract:
    OBJECTIVE: To determine the best alternative therapy for acute gouty arthritis when nonsteroidal antiinflammatory drugs or colchicine are contraindicated. METHODS: Thirty-one patients with crystal proven gout presenting with an acute attack of < 5 days' duration were treated prospectively with either a single intramuscular injection of adrenocorticotropic hormone (ACTH) 40 IU or triamcinolone acetonide 60 mg. The patients were followed for 30 days. RESULTS: Resolution of all symptoms occurred at an average of 8 days for both groups. No adverse reactions were noted in either group; however, there were 11 reinjections in the ACTH group and 5 reinjections in the triamcinolone acetonide group. Two patients from the ACTH arm were transferred to the triamcinolone acetonide arm because of rebound arthritis. CONCLUSION: Although recent studies of ACTH and triamcinolone acetonide have demonstrated efficacy and safety comparable to indomethacin, in a direct comparison of the 2 at the doses used, triamcinolone acetonide resulted in fewer rebound attacks and treatment failures than ACTH and required fewer reinjections.
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