Description

Prednisolone is a corticosteroid used for treating severe gout attacks, particularly in patients who cannot tolerate NSAIDs or colchicine. It works by suppressing the immune response and reducing inflammation through multiple mechanisms. A landmark study by Man et al. (2007) in the Lancet demonstrated that oral prednisolone was as effective as naproxen for acute gout treatment, with a similar safety profile over a short course. Another randomized trial by Rainer et al. (2016) showed that prednisolone was non-inferior to indomethacin for pain relief in acute gout, with fewer adverse effects. However, long-term or frequent use of corticosteroids can lead to significant side effects, including osteoporosis, diabetes, and increased susceptibility to infections. A retrospective cohort study by Janssens et al. (2017) found that repeated courses of oral glucocorticoids were associated with an increased risk of adverse events in gout patients. Therefore, while effective, prednisolone should be used judiciously, typically reserved for severe attacks or when other treatments are contraindicated.